These loving, affirming parents are suing the doctors who performed medically unnecessary surgery on their son before they met and adopted him. Their son was, like about one in two thousand children, born intersex. His doctors decided the baby should be a girl, and surgically altered his genitals to match this gender assignment.
“MC” is ten years old now, and has identified himself as a boy.
His parents trust him to know who he is.
They’re distressed that his body was surgically changed before he was old enough to say what he wanted, changed for no other reason than that it didn’t look like what people thought a girl’s, or a boy’s, body should look like. MC is confused and hurting now, and it didn’t have to be this way.
Every time I hear about the pain a child went through because someone with decision-making power decided their body wasn’t good enough, I want to find them all (the children, of course) and start a big cuddle pile. Then I remember they’ve been touched enough against their will, so I go cuddle a stuffed animal instead and share these stories as much and as far as I can.
Unnecessary surgery disables children. Surgery creates scarring. For intersex children, this often means chronic pain, loss of sensation, and even injury as their body grows, but is restricted by surgical scar tissue and muscle damage. These are all physical disabilities, usually with lasting symptoms, that wouldn’t have been there had the surgery not happened. Gender dysphoria, and the sense of bodily violation, can lead to emotional pain and mental health struggles like anxiety, depression, and thoughts of self-harm. Sometimes, the outcome is suicide, or chronic and disabling psychological struggles.
A word on unnecessary surgery in general: I’m not a medical practitioner, and most definitions of medical necessity out there revolve around what insurance will and won’t cover, so I’m defining medically necessary for my purposes, as any procedure needed to save a person’s life or significantly improve their functioning.
A child who’s urethra is blocked or otherwise doesn’t work to carry urine out of the body should have surgery if it will help. A child who’s urethra just doesn’t look the way other children’s urethras look, or is pointed in a way that won’t let the child stand up to pee like boys and men are “supposed” to, should not have surgery unless or until they’re old enough to decide what they want.
No one should decide that purely cosmetic surgery should be performed on someone else’s body.
Surgery is stressful. Surgery is traumatic.
Not understanding what’s happening to your body is terrifying, and that fear doesn’t leave once the bad time is over.
It doesn’t matter whether a child can consciously remember the surgery. It, like abuse, leaves its imprint on the body and psyche.
This isn’t just rhetoric here; I know what I’m talking about.
Between my birth and shortly after my fifteenth birthday, I went through over 20 surgeries. Most of them were on my head and face. None of them were on my genitals. I remember few of them. All of those surgeries were necessary to my survival and my functioning, but I also know the toll they’ve left on my mind and body. There are only so many times you can take a body apart and put it back together again before it just doesn’t feel right or function cohesively.
To leave that toll just because a child’s body doesn’t conform to arbitrary gender or attractiveness standards is violence.
Adults are free to get whatever cosmetic or medical surgeries that aren’t strictly necessary they want. Yes, we could fault beauty norms for pushing some adults into thinking that they have to have surgery to improve themselves, but ultimately most adults are legally and ethically free to make their own choices.
Children aren’t given those choices. Babies and very little children aren’t able to make such choices. Children’s bodies are growing and changing—should not be interfered with unless interference is needed for survival and healthy growth. If it’s possible to facilitate a child being able to breathe, talk, walk, and otherwise move their body without inflicting lasting harm, then certainly that can and should be done.
We must not take the bodies of little children apart just to put them back together the way we think they should go.
The validation for surgery on intersex babies came from a psychologist named John Money.
This was the result of his experiment with which doctors have justified operating on intersex children.
One of the medical establishment’s goals is to prevent disability and illness. The Hippocratic Oath commits healthcare providers to never do harm.* How then can medicine, as a whole, ethically justify procedures that can cause physical or psychological disability.
We should not be disabling children. The fact that the justification for disabling children in this way came from an experiment that harmed a child–a human being–so greatly is horrifying.
Some people suggest genital-normalizing surgery can protect children from being bullied. People – children and adults – will always, always find something to bully someone else about. That’s not going to change. Submitting a child to surgery with unknowable results isn’t going to change social structures or the bullying problem. (I was going to say that surgery wouldn’t change human nature—which is also true—but I believe that the pervasiveness and escalation of bullying have much more to do with social structures than human nature.
I’d argue too that every child deserves privacy, including privacy from other children, so that if they don’t want to, or don’t feel safe with, showing their bodies to their peers, they don’t have to. It’s ridiculous, actually, that on one hand adults preach to children about modesty while on the other hand children are not given the chance to practice any form of modesty if they wish too.
I should clarify here that I don’t think there’s anything bad or immodest about bodies, or about being naked around other people in places where that makes sense—like locker rooms. What I take issue with is the contradictory messaging children are given around privacy, and the lack of options for children to make decisions around their own bodies. It’s shameful how little bodily autonomy children are allowed.
The tendency to bully around difference is a massive topic that can, and has filled books. People will always find difference, even if it’s not staring them in the face.
So, if we don’t do genital surgery on intersex children, what do we do about assigning gender? I don’t know. I’d like to think that we could just raise children in a non-gendered, or maybe a multi-gendered, way until, or if, they choose a gender for themselves. Most Western and westernized cultures are so dependent on the gender binary, for everything from naming children to assigning them to sports teams and other recreational activities, that my wee brain just can’t quite envision how these cultures could move past this tendency to raise children without actions that lock their existence into a gender binary. I wish I had that kind of expansive imagination, and even more that if I had that imagination it could make real cultural change.**
The only thing I know for certain is that hurting children is bad, and that having a medical degree and seeing genitals that don’t fit what your textbooks tell you is normal is not a free pass for causing hurt.
*For a modern version of the Hippocratic Oath, take a look here.
** Someone did have that kind of expansive imagination.