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A Call for Urgent Change – World Mental Health Day 2018

Intersex people are born with sex characteristics that vary from standards for male and female bodies. All around the world intersex infants and children are subjected to unconsented and medically unnecessary interventions, including surgical procedures, hormonal treatments, exposure to multiple examination, exploration, photography and filming and mechanic operations. Intersex people worldwide face the profound consequences of those interventions, including sterility, insensitivity and chronic pain. Today, on World Mental Health Day, it is necessary to remember that those interventions also have an extremely negative impact on intersex people’s mental health. Trauma, panic attacks, depression and suicide are too commonly associated with those violations of the right to physical integrity and self-determination.

The immediate identification of intersex issues as bodily issues can render invisible the centrality of mental health rationales to justify so-called “normalizing” interventions.  Irreversible surgical procedures are frequently intended to prevent mental health issues issues that automatically associate bodily diversity with suffering. In other cases, interventions are justified to promote a healthy bond between mother and child, to prevent discrimination at school and to avoid rejection by potential sexual partners in adulthood and its consequences for self-esteem. Many young intersex people, everywhere, are affected by the combination of dangerous assumptions and even more dangerous steps to “protect” their mental health.

Contrary to medical, legal and social beliefs, unsupported by evidence, intersex young people’s lives do not improve because of early interventions. Quite the opposite; in many cases, intersex youth only get to understand the true meaning of those interventions during adolescence, once confronted with their consequences for their sexual and reproductive health and rights. Those intersex teenagers face not only bodily changes, but also the irreversibility of unconsented and unnecessary actions taken to modify their bodies to make them more acceptable, desirable or lovable.  

Despite widespread assumptions, not all intersex bodies reveal themselves as intersex just after birth, or in the following days, weeks or months. Many intersex bodies become recognizable as such prenatally. And many become recognizable as such during puberty, and many intersex people learn about their own sex characteristics during their adolescence, surrounded by a generalized lack of information, lack of positive representation and overwhelmed by an equally generalized pressure to conform to bodily, gender and sexual stereotypes.

Mainstream medical, legal and social representation of intersex bodies and experiences tend to reduce intersex issues to sex assignment at birth; concomitantly, expanding sex assignment to include a comprehensive “third sex” is presented as the key solution to prevent human rights violations against intersex people. However, this perspective repeatedly fails in recognizing that for many people being intersex only started in adolescence. It also fails to acknowledge that many young persons around the world are suffering right now the consequences of intersex genital mutilation (IGM), and that those consequences, including mental health consequences, deserve to be seriously addressed.

On this World Health Day we call for urgent change. It is necessary to put an end to all medically unnecessary and personally unconsented “normalizing” procedures, but it is not enough. For that change to become real, it is also necessary to ensure intersex youth’s access to information, counselling, systematic and individual advocacy and support, positive representation. Only these can ensure that young intersex people to are fully able to enjoy their sexual and reproductive rights, their right to physical autonomy and self-determination, and the right to be heard in all matters concerning our world.

In solidarity,

The GATE Team