Commenting note: this is about intersex surgery. This is not about male or female circumcision. Please keep your comments to the topic of intersex surgery.
We talk a lot about female and male genital circumcision, but a topic that is sadly undercovered, in my experience, is the surgery performed on children with intersex genitalia.
An intersex person is born with some features typically associated with female bodies and some features typically associated with male bodies (this condition is usualyl medically called a “disorder of sex development”). For instance, their genitalia may look midway between a penis and a clitoris, or they be born with a Y chromosome but be unable to process testosterone, or they may even have two X chromosomes and a Y chromosome. Approximately 1 in 2000 people are intersex; most intersex people identify as either male or female.
Many intersex conditions require surgery for the sake of the child’s health: for instance, the child may need to have a urinary opening created or malignant tissue removed. However, many times, intersex children have genital surgery performed on them for no reason other than to make their genitals look “normal.” Parents may be anxious or distressed if their children don’t look the way a boy or a girl is “supposed” to. It was thought to make the children less likely to identify as the gender that they were assigned if they had ambiguous genitalia.
Okay, what? That’s FUCKED. Let me count the ways in which it’s fucked:
- Sometimes, when you assign someone a gender, you assign them the wrong gender. Let them speak up about what their gender is before you go chopping their genitals up willy-nilly.
- Many people who have had intersex surgery report sexual dysfunction, reduced sensation, or even chronic pain.
- Children raised with ambiguous genitalia are no more at risk for psychosocial problems than children who aren’t.
- Children are fucking acceptable and lovable regardless of what their fucking genitals look like, and people should have the fucking right to decide what happens with their own fucking genitalia.
Basic rule: we should not perform cosmetic genital surgery on infants. Ever. Maaaaaaybe a harm-reduction exception for religious people who would otherwise have their children circumcised in unsafe conditions to please God, but even then we should be working to change the religion’s doctrine to something more respectful of bodily autonomy. Anyway, I don’t think there are a hell of a lot of religions that say “thou shalt not have baby girls with enlarged clitorises”, so we’re in the clear here.
All genital surgery not directly necessary to preserve the child’s health should be delayed until the child is old enough to have an opinion on it. When possible, surgery should be delayed until the child is 18, to prevent the parents from having undue pressure on the children and so that a prepubescent or barely pubescent child won’t decide that looking normal is more important than the risk of never having an orgasm when they’ve never had an orgasm.
Fortunately, at the moment, thanks to the assiduous work of advocates for intersex children, the current standards of care for intersex children have reached the standard of basic human decency. Most clinicians agree that affected individuals and families should be told about the diagnosis, that boys born with micropenises should not be routinely assigned as girls, that surgeries should generally be delayed until puberty, and that not all people need surgical sex assignment at all. Unfortunately, this is for some reason not yet a universal consensus. Progress has been made, but there’s still work to be done in destigmatizing intersex conditions and making sure that intersex people have full bodily autonomy.
For more information about intersex conditions, look at Accord Alliance, the major source for this article.