What is intersex surgery and where is it banned?

Intersex children in Spain can no longer be subjected to medically unnecessary genital surgery under a law that went into effect on Thursday.

The bill, which also allows transgender people aged 14 or older to change their legal gender without a medical diagnosis, carries a raft of provisions to protect intersex youth.

It includes a complete ban on unnecessary intersex surgeries for children under 12. Older children can request to undergo surgery if wanted.

The law also gives parents up to a year to register the sex of babies who are neither clearly male nor female at birth.

It was praised by intersex organisations as a rare move to protect their rights. However, campaigners say dangerous loopholes still exist in many bans, from Spain to Iceland.

Here is everything you need to know:

What are intersex surgeries?

As many as 1.7 per cent of children are born with genitals, reproductive organs, hormones or chromosomes that don’t fit the usual expectations of male and female, according to the United Nations.

They often undergo surgery to bring the appearance and function of their genitalia into line with that expected of males or females, which research suggests can lead to physical and psychological harm

What are the concerns?

Medically unnecessary surgeries on intersex children have been condemned by rights experts and intersex campaign groups.

In many cases, they are carried out on babies and toddlers who can neither understand nor give consent, according to U.S. medical rights group The National Health Law Program.

The surgeries are often irreversible, and can cause pain, infertility, incontinence, loss of sexual sensation, as well as impact mental health, said the U.N.’s “Free and Equal” LGBTQ+ rights campaign.

Intersex rights organisations say they amount to genital mutilation, and stigmatise intersex people as “abnormal”.

“Children are the most vulnerable population and this is their most private part,” said Eli Rubashkyn, a rights advocate at ILGA World, a global LGBTQ+ rights group.

“We are violating and disrepecting that body. We are talking about mutilation.”

Where are intersex surgeries banned?

More than 50 countries signed a U.N. statement in 2021 calling for concrete measures to protect intersex people from discrimination and abuse, including medical interventions.

Two year later and only six nations have legal provisions against intersex surgeries, according to an upcoming report by ILGA World shared with Openly.

Malta was the first country to ban unnecessary surgeries on children with sex variations in 2015. Since then, Germany, Greece, Iceland, Spain and Portugal have followed suit.

Other countries such as Austria, Cyprus and France have also tabled proposals for bans, according to ILGA World.

Are the bans enough?

Intersex campaigners demand legal protections, but say they often carry loopholes.

For example, Icelandic doctors might operate on a child’s genitals if the urethra is not at the top of their penis, said Rubashkyn, as this is not always seen as an intersex trait.

Germany also allows parents to petition for permission to carry out surgery, if they believe it to be in the child’s best interests.

Activists say parents can also get around Germany’s law by avoiding a diagnosis.

“There is an urgent need to protect intersex persons and ban these harmful practices, which violate their right bodily integrity and self-determination,” Dan Christian Ghattas, Executive Director of OII Europe, an umbrella organisation of intersex-led rights groups.

Reporting by Lucy Middleton.

GAY TIMES and Openly/Thomson Reuters Foundation are working together to deliver leading LGBTQ+ news to a global audience.

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