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Experts Urge End to Nonconsensual Intersex Surgeries

Surgeons’ Cosmetic Preferences for Appearance of Genitals Don’t Negate Informed Consent

LGBT+ community-led march protests for intersex rights, London, United Kingdom, July 24, 2021. © 2021 May James/SOPA Images/Sipa USA via AP Photo

Teams of prominent scientists and ethicists have called for the end of medically unnecessary nonconsensual surgeries on intersex children in two new papers.  

On the heels of the United Nations Human Rights Council’s first-ever resolution affirming the rights of intersex people, the papers signal growing international resolve to address rights violations experienced by people born with variations in their sex characteristics, sometimes called intersex traits.  

Since the 1950s, surgeons have conducted irreversible and medically unnecessary “normalizing” operations on intersex children, such as procedures to reduce the size of the clitoris, which can result in scarring, sterilization, and psychological trauma. Intersex advocacy groups, as well as various medical and human rights organizations, have spoken out against these surgeries for decades. Despite a growingconsensus that these surgeries should end, as well as global progress onbanningthem, some parents still face pressure from surgeons to choose these operations for children too young to participate in the decision. 

The authors of one of the expert papers found that surgeons’ subjective cosmetic preferences for the appearance of genitals was one of the most commonly reported justifications in the paper’s sampling of elective “normalizing” surgeries on children younger than 10. Cosmetic appearance of genitals has no validated measure, so the data featured surgeons’ subjective descriptions instead. The authors, including five World Health Organization staff members, concluded that, “Legislating and medical regulatory bodies should advocate for ending the conduct of irreversible, elective, ‘sex-normalizing’ interventions conducted without the full, free and informed consent of the person concerned.” 

The second paper, co-signed by dozens of professionals around the world, including physicians, ethicists, and psychologists, examined the ethical implications of “normalizing” interventions on children’s genitals. The authors conclude that clinicians “should not be permitted to perform any nonvoluntary genital cutting or surgery on any child, regardless of the child’s sex traits or socially assigned gender, unless doing so is urgently necessary to protect the child’s physical health.” 

Both papers advocate that children born perfectly healthy – just a little different – should be free to grow up and make decisions about their own bodies. 

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