BY GARRY WISE AND SIMRAN BAKSHI
Reprinted from The Lawyer's Daily
Reprinted from The Lawyer's Daily
In a highly controversial decision last month, a California
senate committee voted against proceeding with a bill that would ban cosmetic
genital surgery on intersex infants.
The term intersex refers to persons born with
genitalia, chromosomes or reproductive organs that do not conform to a single
gender. Far from unusual phenomenon, it is estimated that almost two per cent
of the population is born with some form of intersex variation.
This bill, which would have been the first of its kind
in the United States, proposed to defer surgical procedures on intersex
children under the age of six, except for procedures deemed medically necessary
by the Medical Board of California.
The bill proposed to permit intersex children the
opportunity to be involved in the critical decisions made about their gender
identity and health. Its advocates also argue that early “normalization”
procedures can lead to incorrect gender assignments and permanent loss of physical
sensation.
This is an emerging social policy issue that raises
difficult medical, ethical and parental issues.
The practice of genital surgery on intersex infants
has long been criticized by the United Nations and advocates for the intersex
community argue that the very notion that anatomically atypical sexual features
must, by definition, be “fixed” is problematic at its core
The Canadian Bar Associate’s Sexual Orientation and
Gender Identity Community Section (SOGIC) and Health Law Section recently put
forward similar recommendations to the Standing Committee on Health in relation
to its study of LGBTQI2S health in Canada. The CBA specifically expressed
concern regarding the exemption provided for at subsection 268(3) of the Criminal
Code as it relates to the rights of intersex children, which allows
surgical procedures for the purpose of “normal reproductive functions or normal
sexual appearance or function”.
As the CBA submissions explained:
We are not suggesting a
complete ban on surgical procedures. We recommend amending the Criminal Code to
postpone genital normalizing surgeries on children until the child can
meaningfully participate in the decision – except where there is immediate risk
to the child’s health and medical treatment cannot be delayed.
Opponents of the California bill claimed it was overly
prescriptive in shutting out parents and medical professionals from decisions as
to whether surgical intervention is in a child’s best interests. They argued the
bill unfairly assumed that parents and doctors opt for surgery without due
consideration of the risks and benefits to the child, and that no good would
ultimately come from deferral to age six, since parents would then, in any
event, be required to make these decisions on behalf of their still-infant
children.
Is a child likely to suffer greater harm from early
surgical intervention which occurs without the child’s input? Can a child
legally provide true consent to an intersex surgery, pre-puberty? Is a child
more likely to be adversely affected if surgery occurs before rather than after
puberty? Should a parent be entitled to decide about a child’s gender identity
without the child’s involvement?
The answer to these questions may well vary from child
to child. Is a one-size-fits-all ban on intersex surgeries for all children
under the age of six, then really the answer?
While the law must protect a child’s right to
develop and to identify with one, both or neither gender; it must also be flexible
enough to recognize that there will be circumstances where it may be in the
child’s interest for the parent to decide on action earlier rather than later.
Beyond that, society’s “binary” understanding of
gender must change.
Decisions regarding intersex surgery must be based on what
is genuinely best for the individual child. They should not be based on discrimination,
fear or stigma.
This article was originally published by The Lawyer's Daily (www.thelawyersdaily.ca), part of LexisNexis Canada Inc.
- Garry J. Wise, Toronto
Visit our Toronto Law Office website: www.wiselaw.net
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