Medical Harm and Human Rights in Intersex Bodies

Introduction

Modern society still holds strong negative stereotypic beliefs about intersex people. Often, social pressure prompts surgical operations geared toward transforming gender identity into a form considered acceptable through the lens of the community. As a result, children have undergone medical interventions that lack scientific proof of improving intersex lives. Unfortunately, these processes take place without the person's consent, because the children involved lack decision-making capacity. The effects include heightened risk of infertility, incontinence, and various forms of psychological harm — all inflicted in the name of making a child conform to how the community believes people should appear. These procedures are irreversible, despite the absence of evidence that deferring them would cause any harm or undesired outcome.

Such concerns have prompted human rights bodies such as Amnesty International to oppose these violations and compel governments to protect the intersex community from harmful medical interventions. This paper discusses the harms of those medical interventions and examines how policy should protect vulnerable intersex children. It also describes the challenges parents of intersex children face when deciding whether to retain their child's biological identity or pursue corrective interventions.

Social Discrimination and the Politics of Intersex Bodies

According to Fausto-Sterling (1–2), people with intersex bodies are discriminated against in various spheres of life, including sports. For example, Patino was banned from athletic participation due to her undefined gender identity, and her achievements were erased from Olympic records, at least for a period. However, in a legal battle, she prevailed against the sex-testing approach of the IAAF, declaring that "I knew I was a woman" (Fausto-Sterling 2). Her case demonstrates the significance of self-determination in defining gender identity. Although Patino did not display any unusual medical condition, Carpenter (449) notes that medicalization frequently intrudes even in such ordinary circumstances, meaning that intersex bodies are routinely subjected to unnecessary procedures lacking scientific support.

As Fausto-Sterling (3) explains, gender is a psychological transformation encompassing behavioral expressions. Subjecting children to physical medical interventions therefore does not alter the original psychological orientation, meaning such procedures can cause irreversible harm. The primary focus of any decisions about intersex bodies should be the politics of the body without discriminating against existing differences (Fausto-Sterling 8–9). One of the central issues surrounding intersex is whether only two sexes should exist. Fausto-Sterling (78–80) analyzes this foundational question: in the 1970s, it was considered obvious that people constituted only two genders, male and female, and any discussion of intersex was viewed as strange and unacceptable.

Because intersex children were regarded as biologically and medically abnormal, medical interventions were used to alter their anatomy, even as some scholars acknowledged that sex differences were partly a matter of social construction. Multiple sex categories were identified — such as fems, herms, and mems — giving rise to various theories explaining these differences. Intersex has gradually become a recognized gender concept deserving of state protection. For its opponents, this recognition has been unsettling; for its proponents, it has been liberating. Fausto-Sterling (79) argues that the management of intersex births requires change for several reasons. First, there should be no unnecessary infant surgery — that is, procedures not aimed at saving a life or genuinely improving physical wellbeing should be eliminated. Second, sex assignment by physicians should be treated as provisional, designated as either male or female based on probability and existing knowledge, thereby allowing children to make their own decisions when they grow up. Third, because parents and children are likely to face discrimination and psychological distress, the medical team should provide education and counseling services informed by the severe harms caused by intersex management practices dating back to the 1950s.

Avoidance of Harm Through Alternative Interventions

Medical interventions designed to alter the gender of intersex children have involved the mutilation of infant genitals. Gender politics sometimes invokes the prevalence of female genital mutilation (FGM) in certain cultures as justification for such gender alterations. Some medical experts also regard support for intersex conditions as misguided, arguing it denies children future happiness (Fausto-Sterling 79). However, these medical transformations cause more harm than good. Genital surgery is largely a cosmetic procedure driven by social expectations of a two-sex structure. For decades, these methods have not produced improvements in sexual function, revealing their inadequacy. Moreover, follow-up on operated children is rarely conducted, leaving insufficient data on which to base reliable interventions.

According to Cheryl Chase, the medical procedures performed on her are more damaging when understood in the context of a later-developed emotional identity (Fausto-Sterling 80). She sank into depression and developed suicidal thoughts after discovering what had been done to her — and, more disturbingly, found no support from intersex specialists. She states: "I expected to find some help. I thought that these doctors would have excellent connections to therapists skilled in dealing with histories like mine. They have none, nor do they have any sympathy" (Fausto-Sterling 80). Chase's experience is not unique. In 1996, a mother declined medical recommendations to assign a female gender to her intersex child (Fausto-Sterling 81). Chase and like-minded individuals and organizations played a significant role in transforming medical practices in the United States. Angela Moreno, for instance, suffered psychological damage as a result of deception surrounding corrective surgery and became an ISNA activist advocating for intersex rights (Fausto-Sterling 84). Many adult intersex persons feel that surgery has been an affront to their dignity and urge the establishment of policies that protect them and their children. For these reasons, the protection of intersex bodies is paramount in fighting sexual discrimination, and human rights bodies must advocate for reviewing any policies, regulations, or practices that lead to unfair treatment (Carpenter 480–481).

It is worth noting that so-called corrective surgery inflicts pain on the person, compromising human rights. Research indicates that intersex persons affected by earlier surgeries experience residual pain and hypersensitivity even in later life. Complications such as stenosis are also common following vaginal surgery (Fausto-Sterling 85). When children discover that the physical and psychological pain they endure was caused by physicians, they are more likely to develop negative outcomes than if they had instead received support acknowledging their intersex identity. For example, when young girls undergo vaginal surgery and parents are instructed to use dilators to prevent vaginal closure, the effects are likely to be detrimental to both the child and the parent. A similar impact is felt when young intersex boys are subjected to stimulation procedures to facilitate measurement of penile growth (Fausto-Sterling 86).

One of the most troubling aspects of medical harm to intersex persons is the prevalence of repeated surgery. Up to 80 percent of those who undergo initial procedures are subjected to additional operations. The result is continuous painful experiences with no assurance of a positive outcome. Such procedures are also high risk, and success rates are significantly low. Research indicates that before patients accept these processes, they require intensive psychological reinforcement, suggesting their distress is driven primarily by societal opinion and expectation rather than by any internal need. If expected outcomes are not achieved, patients are likely to decline further surgical operations (Fausto-Sterling 86).

On a more nuanced note, some adult men have shown a positive response to hypospadias surgery, reporting sexual milestones such as age at first intercourse. Some of the challenges that intersex males face — including low self-esteem — can be partly addressed through corrective surgery, which may foster greater self-confidence (Fausto-Sterling 87). For this reason, some difficulties experienced by intersex males may be resolved through targeted interventions, particularly because many underlying deficits are psychological rather than anatomical. For men with severe hypospadias, however, surgery registers low rates of success (Fausto-Sterling 87).

Conclusion

The harms of medical interventions on intersex bodies is not a new concept. For a long time, medical and social assumptions have prompted surgical operations on intersex persons in the belief that doing so promotes a better life. However, substantial research has shown that these interventions produce little benefit for patients or the parents of intersex children. Accordingly, a reversal of existing policies and the creation of restrictions discouraging these surgeries must be implemented. The fundamental objective is advocating for the human rights of intersex persons by banning unverified and non-consensual medical procedures. Equally important is educating communities about the existence of intersex individuals and the principles of equality that should govern their treatment.

In particular, accommodating intersex persons in social environments and providing them with equal opportunities is essential. The traditional two-sex system must be expanded to incorporate additional identities, alongside broader sensitization efforts establishing that sex should not be determined on the basis of genitalia alone. These reforms, pursued collectively by human rights bodies, medical practitioners, policymakers, and communities, offer the most viable path toward genuine protection and dignity for intersex persons.

Works Cited

Carpenter, Morgan. "The 'Normalisation' of Intersex Bodies and 'Othering' of Intersex Identities." The Legal Status of Intersex Persons, 2018, pp. 445–514, doi:10.1017/9781780687704.028.

Fausto-Sterling, Anne. Sexing the Body. Basic Books, 2000.

Spade, Dean. "Resisting Medicine, Re/Modeling Gender." Identity Politics at Work, 2003, pp. 15–37, doi:10.4324/9780203358269-5.

Stone, Sandy. "The Empire Strikes Back: A Posttranssexual Manifesto." Camera Obscura: Feminism, Culture, and Media Studies, vol. 10, no. 2, 1992, pp. 1–26, doi:10.1215/02705346-10-2_29-150.

"US: Harmful Surgery on Intersex Children." Human Rights Watch, 28 Oct. 2020, www.hrw.org/news/2017/07/25/us-harmful-surgery-intersex-children.