Intersex youth are also being hurt by anti-trans laws, advocates say

Ori is intersex, meaning they were born with sex characteristics associated with both male and female bodies. Turner worried that Ori might face discrimination in organized sports.

“I was like, okay, I’m going to try to push the kids more into art and music and other things,” said Turner, who lives in Washington state. If her children decided to play sports, she would would support them, Turner said, but she didn’t encourage them to sign up for little league or swim teams.

“I know it’s a minefield,” says the mother of three and advocate for intersex youth.

During the pandemic, Turner began to reflect on those choices: “It became clearer how much the politics of everything was affecting my parenting at a subconscious level.”

A guide to the words we use in our gender reporting

The recent surge in state legislation targeting transgender and queer children has alarmed Turner and other intersex advocates. Many of these bills explicitly target trans children and would make it harder to learn about themselves, play with their peers and receive the kind of affirmative care they have sought for many years, experts say. But the bills could also set a damaging precedent for intersex children, whose needs and experiences are often overlooked, advocates say.

“We felt like we were at war for a long time – we were just trying to care, to talk to each other, to navigate [the medical system]’ Turner said. “It’s devastating to see the war level go up like that when you thought you were actually making progress.”

Many of the bills that would ban gender-affirming treatments for trans minors, such as puberty blockers, breast surgery, or hormone therapies, make explicit exceptions for people with intersex characteristics. In many cases, surgical procedures that are rarely performed in non-intersex children — such as vaginoplasty, in which a vagina is created or altered, or gonadectomy, in which a child’s gonads are removed — are performed when an intersex child is an infant or toddler is. But those exceptions won’t protect those children, proponents say.

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“There are many overlapping issues between the trans and intersex communities,” said Bria Brown-King, engagement director at InterACT, an organization that advocates for intersex children. “What both communities are really fighting for is the right to bodily autonomy.”

According to interACT: Advocates for Intersex Youth, people born with intersex characteristics make up at least 1.7 percent of the population — a figure comparable to the number of people born with red hair. And that number doesn’t include people whose intersex characteristics reveal themselves later in life.

People can exhibit a variety of intersex characteristics, such as: B. the absence of the usual XX (for females) or XY (for males) chromosomes, undeveloped or partially developed sex organs, or a mix of physical sex characteristics (people with androgen insensitivity syndrome, for example, have the physical characteristics associated with women, but internal testicles instead of a uterus). While intersex describes a person’s biological characteristics, it is not a gender category — people with intersex characteristics can identify as male, female, non-binary, or any other gender identity.

The medical community’s response to people with these traits has varied over the years. Many US doctors perform surgeries on intersex infants and young children to fit them into a more typical male or female body. While some surgeries are required for a child’s body to function properly, many procedures are more cosmetic in nature and are designed to “normalize” the child’s appearance.

These surgeries are also a relatively recent phenomenon: U.S. physicians began performing them in the 1950s, a time when “the pressures to conform to social norms were often unrelenting,” wrote three former U.S. surgeons general in an analysis of the topic from 2017.

Today, doctors may recommend these surgeries, but encourage parents never to tell their children about them, advocates say, meaning some never find out they’re intersex. Doctors who advise parents to have these surgeries often cite concerns about the emotional trauma intersex children might have or about future health risks.

Gender-affirming childcare bans like last time Passed in Alabama and Arkansas, the law would ensure doctors could continue to perform these surgeries on infants and young children and give them other interventions such as hormone therapies — treatment that trans teens would be denied under the same laws. Lawmakers promoting these kinds of laws say they are necessary to protect children from health risks and prevent trans minors and their parents from making medical decisions they would later regret.

While some of the treatments that trans youth and adults seek may be similar to those given to intersex children, there is one key difference, Brown-King said: trans people consent to these interventions, while intersex people typically do not. These gender-affirming childcare bans also perpetuate a harmful status quo for intersex youth, advocates say — one that forces parents and doctors to choose a gender in ways that could cause long-term physical and psychological harm.

A growing number of medical professionals have spoken out against non-consensual surgery on intersex children, saying they should wait until children can make an informed decision about their needs. Not only are these procedures unethical, these doctors say, but they can create a number of irreversible complications, including scarring, sterilization, chronic pain, sexual dysfunction, and nerve damage.

There are also long-term psychological effects. Because follow-up care can be invasive (children may have repeated genital exams throughout their childhood), many intersex people feel stigmatized and traumatized by their doctors and develop shame around their bodies, Brown-King said. This damage can be compounded for intersex people of color who already face systemic barriers to care.

In 2017, three former U.S. surgeons who served under the Bill Clinton and George W. Bush administrations wrote a paper concluding that these surgeries to “normalize” infants were “unjustified” and often lead to greater physical and psychological damage.

“We hope that professionals and parents facing this difficult decision will heed the growing consensus that the practice should stop,” they wrote.

Brown-King said these surgeries are ultimately based on fear and ignorance: they require parents and doctors to “make a lot of assumptions about what gender they think they would grow their child up with and what kind of body they would want their child to have.” have.” These assumptions are rooted in the idea of ​​a binary gender and gender identity, Brown-King added.

Laws targeting trans children reinforce those misconceptions, Brown-King said — and it’s not just about trans and intersex people. Advocates have pointed to laws banning trans women from participating in women’s sports as of particular concern: some have proposed genital screening to confirm children’s gender; Some have empowered private individuals to enforce the bans, allowing them to sue schools if they suspect a trans girl is playing against cis girls.

“That means anyone’s gender can be questioned,” Brown-King said. Pointing to recent political debates about how to define a woman, “we have an image in our minds of the perfect type of woman” — someone white, slim with facial features that are “unrealistic” for many women, Brown-King said. “If you have a body that doesn’t fit into that box, well, it’s up to you to do something about it.”

Turner, the parent and former interAct board member, added that physicians who care for transgender children in a gender-affirming manner tend to be better equipped to care for intersex patients. This includes simple behaviors that make children feel safe, such as B. Using their correct pronouns.

Because of her public advocacy, Turner frequently answers questions from parents seeking advice on how best to support their intersex child. In response, Turner will often share the TED talk they gave with Ori when Ori was 10: There’s comfort to parents in knowing that Ori is happy, healthy, and confident in her identity, Turner said.

Ori, 15, is like any other teenager, Turner says — a “brilliant” non-binary kid who likes anime and art and is always on the phone. Despite all the anti-trans rhetoric, Turner is worried about the safety of Ori and her other two Children.

Turner particularly misses the pre-pandemic days when Ori attended a children’s camp organized by Gender Odyssey, an organization for transgender youth.

“I remember once asking, ‘Are you all talking about being trans or intersex?’ ‘ Turner recalled. “And Ori said, ‘No, we don’t talk about stuff like that. We just play and we all get each other.’ ”

“I thought, okay, we’re making the right choice. You are really happy.”