Historic Report Calls for End to Nonconsensual Surgeries on Intersex Infants

The United States Department of Health and Human Services has published a landmark report addressing the health inequities faced by intersex individuals. This unprecedented document highlights the significant harm caused by surgical procedures imposed on infants and others without their consent.

The report, titled "Advancing Health Equity for Intersex Individuals," was released by the Office of the Assistant Secretary for Health, led by Adm. Rachel Levine, the first openly transgender official to be confirmed by the U.S. Senate.

Recognizing the Harm

According to the report, there is increasing evidence that surgical interventions performed on intersex infants can cause enduring harm, such as stigma and a lack of trust in medical professionals. Historically and currently, medical practices have often prioritized surgical alterations to make infants conform to a binary sex, rather than addressing the health care needs specific to intersex individuals.

Research and advocacy efforts by intersex individuals have documented that non-consensual, medically unnecessary surgeries can lead to lifelong harm. These interventions affect individuals into their adolescence and adulthood, and intersex adults often encounter significant challenges in accessing high-quality, affirming health care.

The report defines intersex as an umbrella term for individuals born with variations in their sex characteristics or reproductive anatomy. Approximately 5 million people in the United States, or about 1.7% of the population, fit this definition, exhibiting 40 identified variations.

Impact and Challenges

These variations are most commonly identified at birth or during puberty, but adults may also discover intersex traits while seeking fertility care or through other unrelated medical procedures. While some intersex individuals may require specialized health care, many variations are considered a natural part of human diversity and do not threaten overall health. Nonetheless, many intersex individuals report undergoing medical interventions because their variations have been treated as disorders.

Surgical interventions can result in numerous adverse physical and mental health outcomes for intersex individuals. These include significant scarring, loss of sexual function, urinary or vaginal complications, chronic pain, and early-onset osteoporosis. Intersex people experience disproportionate rates of trauma and mental health issues due to a lack of affirming care.

Despite these risks, some medical professionals still encourage parents to consent to surgeries for intersex infants, often citing potential stigma associated with natural anatomical differences as justification.

Guiding Principles for Health Equity

The report suggests several guiding principles to enhance intersex health equity. These include protecting the civil rights of intersex individuals, supporting the role of parents in raising their intersex children, and promoting bodily autonomy and informed consent.

Additionally, the report emphasizes the importance of fostering self-acceptance among intersex individuals. Discussions about intersex variations can help many intersex adolescents and adults appreciate their bodies, thereby improving overall self-acceptance and mental health.

"Over the past decades, a growing body of evidence and advocacy by intersex people has demonstrated that current medical practices for intersex patients, especially children, can cause lifelong harm and must be reevaluated," states the report. "Even as this report acknowledges the pervasive barriers intersex people face in our society and health care system, it makes clear that, when intersex people are affirmed and receive high-quality care, they can thrive."

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