New York City Health & Hospitals, the largest public healthcare system in the United States, has instituted a policy to defer all medically unnecessary surgeries on intersex children. The move is a major boost for Intersex rights following City Council legislation earlier this year that mandates public education on the issue.
Intersex people, or people born with variations in their sex characteristics, make up approximately 1.7 percent of the world’s population. Since surgeons in the US popularized cosmetically “normalizing” surgeries on infants to remove gonads, reduce the size of the clitoris, or increase the size of the vagina in the 1960s, these practices have become widespread in the country. Since the 1990s, intersex advocacy groups, as well as a range of medical and human rights organizations, have spoken out against the operations and called for regulation.
New York City has seen demonstrations outside hospitals where the surgeries are still performed in recent years. A former city health commissioner, herself a pediatrician, has also called for an end to the surgeries.
Despite growing consensus that these surgeries should be a thing of the past, parents continue to face pressure from some surgeons to choose medically unnecessary operations when their children are too young to participate in the decision. In 2016 and 2017, I interviewed parents across the US, including in New York, who described how surgeons urged them to elect these procedures for their perfectly healthy children. I also heard from doctors that they felt uncomfortable that the operations were still unregulated. In the past year, hospitals in Chicago and Boston have committed to ending these high-risk surgeries.
New York City’s new policy closes that gap for its 70 facilities, and sends a message of affirmation and respect for bodily diversity. “The rights of the child to be protected from harm should take precedence over the demands of parents for intervention,” it reads. The policy also squares with a new question on the Human Rights Campaign’s Healthcare Equality Index, which now asks hospitals nationwide whether they have a policy to defer unnecessary intersex surgeries until the child can participate in the decision.
Hopefully, this is the beginning of a nationwide trend in which hospitals can proudly answer “yes” to that question.