Admiral Rachel Levine at the Department of Health and Human Services
The Department of Health and Human Services has released a first-of-its-kind report on health equity for intersex individuals, citing the lasting harm surgical interventions inflict on infants and others subjected to nonconsensual procedures.
Titled “Advancing Health Equity for Intersex Individuals,” the groundbreaking paper was issued by the Office of the Assistant Secretary for Health, led by Adm. Rachel Levine, the first out trans official confirmed by the U.S. Senate.
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There is “growing evidence that surgical interventions on intersex infants can cause lasting harm, including stigma and medical mistrust,” the report details. “Historic and current medical practices have often focused on surgical interventions on infants to change their sex characteristics to conform with a single sex, rather than the health care needs of the intersex individual.”
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“Research and advocacy from intersex individuals has documented that non-consensual, medically unnecessary interventions for intersex infants can cause lifelong harm. These interventions impact people into adolescence and adulthood, and intersex adults face significant barriers in accessing high-quality care that affirms and meets their needs.”
The report defines intersex as “an umbrella term to refer to people born with differences or variations in their sex characteristics or reproductive anatomy.” An estimated 5 million people in the U.S., or about 1.7% of the population, fall within the definition, displaying 40 identified variations.
Those variations “are most commonly identified at birth or during puberty, but it is also not uncommon for adults to discover they have intersex traits while seeking fertility care or through unrelated medical procedures,” the report states. “While many intersex individuals may require specialized health care, for many intersex people, their variations in sex characteristics are a healthy part of human diversity and do not pose any threats to overall health. Nevertheless, many intersex individuals report facing medical interventions because their variations in sex characteristics have been treated as a medical disorder.”
Surgical interventions can lead to a host of negative physical and mental effects for intersex individuals, including significant scarring, loss of sexual function, urinary or vaginal complications, chronic pain, and early-onset osteoporosis. Intersex people suffer disproportionate rates of trauma and mental health issues due to lack of affirming care, the report noted.
Despite those risks, medical practitioners still encourage parents to have surgeries on intersex infants, citing potential stigma for the natural differences in sexual anatomy a child may display.
The report recommends a set of guiding principles to address intersex health equity, including protecting the civil rights of intersex people, affirming the role of parents in supporting their intersex children, and promoting bodily autonomy and informed consent.
The report also notes the importance of self-acceptance among the intersex population. “Discussions about intersex variations can also enable many intersex adolescents and adults to appreciate their body, improving overall self-acceptance and mental health.”
“Over the past decades, a growing body of evidence and advocacy by intersex people has demonstrated that current medical practices for intersex patients, especially children, can cause lifelong harm and must be reevaluated,” the report states. “Even as this report acknowledges the pervasive barriers intersex people face in our society and health care system, it makes clear that, when intersex people are affirmed and receive high-quality care, they can thrive.”
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