Out gay State Senator Brad Hoylman of Manhattan will introduce a bill requiring informed consent by an intersex minor before doctors can perform non-medically necessary treatment or intervention on that individual, he announced on November 8, Intersex Day of Solidarity.
Hoylman’s bill responds to growing concerns voiced by health experts and intersex advocates about the long-term effects of genital surgeries on infants and children. Intersex individuals, who are born with reproductive systems or anatomy that do not fit the standard definition of male or female, have often been forced to undergo surgery intended to align their bodies with either male or female anatomy. Most of those surgeries are widely considered unnecessary, and many intersex people experience stress later in life because those surgeries do not reflect their gender identities.
In June, City Health Commissioner Dr. Oxiris Barbot and Human Rights Commissioner Carmelyn P. Malalis wrote an op-ed for ozy.com in which they called on medical professionals “to respect the rights of intersex people, use compassionate care with children, and only perform surgery when the health of a child is at imminent risk or it is consensual.”
Numerous intersex advocates say the surgeries that are deemed unnecessary have often led to pain, sterilization, negative psychological effects, and loss of genital sensitivity. The Intersex Society of North America and the American Academy of Family Physicians have both called for an end to medically unnecessary genital surgeries.
Hoylman said he moved ahead with plans for the legislation after meeting with advocates at interACT: Advocates for Intersex Youth and listening to their experiences.
“Experts estimate there are more than 140,000 New Yorkers with intersex traits — they deserve autonomy over their bodies,” Hoylman said in a written statement. “Yet many intersex people are forced to undergo unnecessary and irreversible surgeries that can cause physical pain and emotional distress… I am confident this bill is a safe, responsible way to protect the rights of all intersex New Yorkers.”
Kimberly Zieselman, who is intersex and serves as the executive director of interACT, said in a written statement that “a subset of the medical community” is unwilling to respect intersex voices and, as a result, vulnerable children across the state are suffering. According to USA Today, Zieselman had surgery at age 15 after doctors told her she had a partially formed uterus and ovaries, which they said needed to be removed to prevent cancer. Her parents gave permission to carry out surgery, but it was not until she obtained her medical records as an adult that she learned she is intersex and that the surgery actually was to remove internal testes. She said she never had a uterus or ovaries.
“Genital normalizing surgeries such as clitoral ‘reductions’ and vaginoplasties instill deep shame and sexual trauma in young children when they cannot make a decision for themselves,” Zieselman said. “That these abuses of intersex youth continue after decades of advocacy proves the intensity of the shame and anti-LGBTQ bias at play. We are so grateful to Senator Hoylman for bringing New York to the right side of history.”
Hoylman, who is in the process of crafting the specifics of the legislation, did not specify the age at which minors would be able to provide informed consent for intersex surgeries or how his law would define the parameters under which surgery would be deemed medically necessary or unnecessary.
The Intersex Society of North America states that such surgeries should be reserved for cases when operations would resolve life-threatening metabolic crises, while the American Academy of Family Physicians maintains that the surgeries should be limited to “resolving significant functional impairment or removing imminent and substantial risk of developing a health- or life-threatening condition.”
The issue has become a contentious one in California’s State Legislature, where proposed legislation banning nonconsensual genital procedures on minors has faced resistance from doctors who argue that parents should be the ones to make decisions about their children, according to the Los Angeles Times.
On the local level, New York City’s Commission on Human Rights updated guidance earlier this year stating that intersex people are also covered under discrimination protections on the basis of sexual orientation and gender identity. The health department also updated birth certificate policies this year to offer folks an “X” option, which respects non-binary and intersex people.