Three former U.S. Surgeons General are calling for an end to involuntary medical procedures on intersex babies and children.
“While we do not doubt that doctors who support and perform these surgeries have the best interests of patients and their parents at heart, our review of the available evidence has persuaded us that cosmetic infant genitoplasty is not justified absent a need to ensure physical functioning,” reads a letter from from Dr. Joycelyn Elders, Dr. David Satcher and Dr. Richard Carmona, who served under Presidents Clinton and Bush.
“We we hope that professionals and parents who face this difficult decision will heed the growing consensus that the practice should stop.”
The Intersex Campaign for Equality (ICE) called the statement a “stunning victory for intersex advocates.”
Intersex is a broad term for individuals born with chromosomes, internal reproductive organs, and/or genitalia that don’t fit strictly binary definitions of male or female. Doctors often perform medically unnecessary surgeries on intersex babies to “correct” them, a practice intersex advocates have long argued does more harm than good.
While data is sparse, it’s estimated that up to 1.7 % of the world’s population is born intersex, about the same as the percentage born with red hair.
“This is an important win not just nationally but globally,” ICE said in a statement, “These harmful practices were pioneered in the United States, and U.S. medical institutions have been slow to question them and are instrumental in exporting them throughout the world.”
As far back as 2001, a report in The Journal of the Royal Society of Medicine suggested that performing surgeries on intersex babies led many to feel later they were in the wrong sex. Even those who did feel at home in their bodies showed high levels of psychological distress when they learned about the surgery, which is almost always irreversible.
Procedures can also leave recipients sterile, interfere with urination, or damage sensitive genital tissue, reducing or even eliminating a the ability to experience sexual pleasure.
Earlier this month, a study published in The International Journal of Pediatric Endocrinology indicated that children who were not operated on showed “no major concerns,” despite the certainty of the medical profession that surgery was essential to prevent medical and psychological damage.
“With appropriate medical care and psychological support, it is possible to defer genital surgery,” wrote lead researcher Dr. Pierre Bougnères.
The World Health Organization has urged parents and doctors to wait until intersex children are old enough to decide for themselves whether they want genital surgery or not, and a growing number of countries—Germany, Switzerland, Australia and Argentina, among them—have declared infant genitoplasty medically unnecessary. (In May, Portugal actually banned the practice.)
As the former Surgeons General wrote, “Those whose oath or conscience says ‘do no harm,’ should heed the simple fact that, to date, research does not support the practice of cosmetic infant genitoplasty.”