Friday, 10 July 2009

Surgery on intersex infants and human rights

From the Australian Human Rights Commission:
During 2008, the Australian Human Rights Commission undertook a project on human rights and sex and gender diversity. Following consultations with the sex and gender diverse community, the Commission focused its work for 2008-09 on a project examining the legal recognition of sex on documents and government records. However, many other human rights issues were raised with the Commission during this consultation. One of the issues identified as a priority human rights issue by people who identify as intersex was surgical intervention on intersex infants. As a result, the Commission undertook to raise greater awareness of the human rights implications of this issue.

The Commission has produced a paper on intersex infant surgery and human rights, which can be found on the Commission website.
Unfortunately, it makes no recommendations, merely outlining the issues, which can be summarised as follows:
Some of the benefits in performing gender-related surgery on intersex infants may include:
  • reducing medical risks, such as the greater risk of cancer for some medical conditions, through removal of gonads, or reducing risk of recurrent urinary tract infection
  • reducing the risk that the infant will be rejected by parents, discriminated against or ostracised by peers and broader society
  • acceptance of the sex and gender assigned at birth by most people who are intersex.
Some of the risks in performing gender-related surgery on infants who are intersex may include:
  • the child does not have an opportunity to express their gender identity
  • the child may experience psychological damage due to an incorrect imposition of gender
  • with certain conditions, infertility being certain, as opposed to probable
  • possible complications from surgery, such as haemorrhage.
In some cases, it's not just a matter of "reducing the risks", some degree of surgery is required to ensure urinary and excretary functionality. And later in life, as great a degree of sexual functionality as can be attained too.

What really worries me though are the disbenefits of surgery which is not necessary. That babies should be castrated and sterilised simply to make society and their parents more comfortable is to me, obscene. Rather than mutilating infants, we should be changing society, so that it becomes more educated, and more accepting.

Some parents will reject their child regardless: but that happens in a minority of cases anyway, and we already have systems (poor ones, admittedly) for dealing with that.

There should be a positive recommendation, by the Australian Medical Association and Pediatricians, that surgery to alter the physical sex of infants should be kept to the minimum necessary for pain relief and urino-genital functionality, until the child reaches an age where they can tell us what sex they are, what they want to look like, and how much or how little surgery they require. Then that surgery (if any) should be provided, no questions asked.

If that makes some people uncomfortable - then they should be told to deal with it. Just as they deal with others who may make them feel uncomfortable - people with different skin colours, or who "talk with a funny accent", or who eat strange foods, or who worship different Deities.

It's not the kids' anomalous bodies that are the problem: it's the bigotry and ignorance of others.


pe1biv said...

I fully agree with you on this!

Battybattybats said...


I find myself a little wary at the suggested option of courts making the decisions on surgery as courts are not infallible and bias-free.

But as for pandering to the belief systems and values of the parents nuh-uh! The parents may hold to whatever faith or culture or tradition they choose but dont get to automatically assume that when the child grows they will be happy with the choices made over and to them because of those beliefs as thry may or may not dhare those beliefs.

After all parents have a responsibility to the independant free thinking adult the child will become, they don't own the child.

From cultural initiation scarrification rites to female circumcision to intersex infant surgery to male circumcision the same principle seems to me to operate.

The child when they grow up have a reasonable enough chance to change faiths, to determine the configuration of their own anatomy, to choose for themselves and to regret choices made for them that could easilly have been put off.

Making all those things, ritual body-modification, circumcisions, not-neccessary intersex infant surgery.. all utterly unethical until the child can give consent. No matter the good intentions it reamins unethical.

Simple principal accross a variety of issues.

And the 'avoid discrimination' argument could justify all manner of atrocities. It's high time we stopped pandering above all to conformity and the idea that the biases of current society ane acceptable or justified or inevitable.

Why isn't irrational bias and bigotry in the DSM? They are better candidates for mental illness than most things in there already.

We can and should declare such biases wrong, unacceptable, unjustifiable and treatable.