Written by Kelsey Chieko Babb for AROMidwifery Blog
As we approach Intersex Awareness Day observed on October 26th, I felt compelled to contribute a post highlighting some of the excellent education out there that aims to increase visibility of intersex folks, as well as speak to the campaign to End Intersex Surgeries. Intersex people are those born with a range of biological sex characteristics that may not correspond to being distinctively male or distinctively female (4Intersex, 2018). The Association of Ontario Midwives (2018) reports, “people with intersex traits are a diverse group that face discrimination and often experience trauma when engaging with health care providers, beginning in infancy.”
Historically, cosmetic genital surgeries were performed before 18 months of age for the perceived benefits of early gender assignment (Intersex Society of North America, n.d.). Intersex children were generally not made aware of their condition and their medical histories were withheld from them by their doctors. Intersex treatments and surgeries in this manner are not only an inappropriate and unethical medical practice, it is an infringement on the child’s right to bodily autonomy. According to the United Nations, carrying out these procedures without consent violates human rights.
The United Nations states medically unnecessary genital surgeries should not be performed in light of the many serious, negative impacts they pose on children. The lasting and irreversible nature of repeated surgeries and treatment to intersex children can cause permanent infertility and lifelong pain, scarring, incontinence, loss of sexual sensation, and psychological trauma (United Nations, 2018). Conformation to the gender binary is not a basis for subjecting invasive procedures on otherwise healthy intersex children.
Many medical associations, such as The American Academy of Family Physicians (AAFP) have taken a firm stance against unnecessary intersex surgeries. Their policy reads, “scientific evidence does not support the notion that variant genitalia confer a greater risk of psychosocial problems” (AAFP, 2018). Unfortunately, even the most research based recommendations don’t always make it into current medical practices right away.
Where should midwives stand on these important issues regarding respect for bodily diversity? I believe that just as midwives safeguard and advocate for the rights of birthing people, midwives must also position themselves to advocate for intersex child autonomy. Midwives, as the baby’s primary health care provider, perform the newborn exam and care for the first six weeks of life. Midwives have a role in the identification of a visibly intersex newborn in their care. Therefore, they can hold a great deal of influence by simply addressing the misconceptions with parents, holding space for emotional processes, and further discussing the recommendations for care. Midwifery providers are well poised to help families navigate informed decision making, participate in medical consults, and make necessary referrals for the care of an intersex baby.
“Intersex babies are beautiful just the way they are”
Please consider showing your support by signing a petition to End Intersex Surgery at Lurie Children’s Hospital in Chicago!
Learn More Here! Resources for Intersex Education
InterACT Advocates for Intersex Youth
Intersex Justice Project
Human Rights Watch and interACT Intersex Feature Video
United Nations Free & Equal
Resources for Article:
American Academy of Family Physicians. (2018). Genital surgeries in intersex children. Retrieved from https://www.aafp.org/about/policies/all/genital-surgeries-intersexchildren.
Association of Ontario Midwives. (2018). AOM position statement on intersex child autonomy. Retrieved from https://www.ontariomidwives.ca/aom-position-statement-intersex-child-autonomy
Intersex Society of North America. (n.d.) What’s wrong with the way intersex has traditionally been treated? Retrieved from http://www.isna.org/faq/concealment
United Nations Free & Equal. (2018). United nations for intersex awareness. Retrieved from https://www.unfe.org/intersex-awareness/
4Intersex. (2018). Intersex 101: Everything you need to know. Retrieved from http://4intersex.org/wp-content/uploads/2018/07/4intersex-101.pdf