Health in Difference, 2018
This year’s Health in Difference conference, organised by the National LGBTI Health Alliance, contained a set of presentations and workshops on intersex issues, by intersex people.
Introductory plenary session
Bonnie Hart (AISSGA) gave an insight into intersex lived experience in a 10 minute plenary speech at the start of the conference.
Plenary panel presentation: “Working with intersex people”
The highlight of the conference, for many of us, was the 12-person panel presentation on 12 April: “A panel of intersex people will present their stories and calls for action, including ways of working together, respecting our heterogeneity, and implementing the Darlington Statement.”
Opened by Bonnie Hart and closed by Morgan Carpenter, participants also included Elise Nyhuis, Derek Tys, Peter Low, Cody Smith, Kelly O’Shea, Paul Byrne-Moroney, Steph Lum, Georgie Yovanovic, Candice Cody and Mani Mitchell.
Bonnie Hart (AISSGA) and Mani Mitchell (ITANZ) led a workshop on working with intersex (diverse sex characteristics) clients.
This interactive workshop is for mental health practitioners. It will explore the unique aspects of working therapeutically with the intersex community. We will establish a definition. We will clarify what aspects are similar to other parts of the rainbow community – but more importantly what are unique. Explore and challenge assumption!! Where, as a clinician you can get support. What are the issues. What might be the personal work required. (especially if the presenting narrative includes severe trauma) Depending on time – we may also discuss case studies (to protect confidentiality – compilations of actual cases).
Morgan Carpenter gave a presentation on Progress or prevarication: intersex health and rights in Australia.
Individuals born with intersex variations are routinely subject to ’normalising’ medical interventions, often in childhood. Opposition to such interventions has been met by attempts to discredit critics, and reasserted clinical authority over the bodies of women and men with ’disorders of sex development’. However, claims of clinical consensus have been selectively constructed and applied, and lack evidence. Limited transparency and lack of access to justice have helped to perpetuate forced interventions. At the same time, the diffusion of distinct concepts of sex and gender has separated discourse on bodies from discourse on identities. The construction of intersex as a third legal identity category has been accompanied by pious hopes and unfounded expectations of consequences. The existence of intersex has also been instrumentalised for the benefit of other, intersecting, populations. The creation of gender categories associated with intersex bodies has created profound risks: a paradoxical reinforcement of a narrowed and normative gender binary, maintenance of medical authority over the bodies of disordered females and males, and claims that transgressions of social roles ascribed to a third gender are deceptive. Neither medical nor third sex models provide individuals born with non-normative sex characteristics the same rights to bodily integrity and self-determination that other populations generally take for granted. Australian attempts at reforms to recognise the rights of intersex people have either failed to adequately comprehend the population affected or lacked implementation. The effect is that intersex bodies remain ’normalised’ by medicine, while society and the law Û÷othersÛª intersex identities. That is, medicine constructs intersex bodies as either female or male, while law and society construct intersex identities as neither female nor male. An emerging human rights consensus demands an end to social prejudice, stigma and forced medical interventions, focusing on the right to bodily integrity, and principles of self-determination.
Steph Lum (Australian Human Rights Commission) gave a presentation on taking a human rights perspective to intersex healthcare.
The clinical management of whole-of- life intersex healthcare raises a number of human rights considerations. International human rights instruments uphold the right to health of all people. When considering the right to health for people with intersex variations, there are important intersections with disability rights, the right to bodily and mental integrity and autonomy, and the right to be free from torture and experimentation. The Australian Human Rights Commission is currently inquiring into medical interventions undertaken in the management of the healthcare of people with congenital variations in sex characteristics. As part of this project, the Commission will be consulting with people with intersex variations, parents and carers, medical professionals, and government decision-makers. By asking the question ”How can we best protect the human rights of people with congenital variations in sex characteristics in the context of medical interventions?” the Commission will develop recommendations that support clinical practice within a human rights framework.
Cody Smith (A Gender Agenda) gave a presentation on building better healthcare outcomes for intersex people:
The Darlington Statement highlights 23 areas of improvement necessary to start producing better healthcare outcomes for intersex people. Much more than just bringing an end to medical intervention, a discussion needs to start happening around building trust with intersex patients. Intersex people are often overlooked and misunderstood, and faced with difficult challenges when it comes to accessing medical services. A bad experience can become another obstacle. Today there are many intersex people who will avoid doctors if they can, this shouldn’t have to be the case. So how do we start deconstructing those barriers? The diversity of intersex people and their needs calls for better understanding. From that position we can start to change the dialogue and processes around intersex to better incorporate those needs. Care needs to be taken to respect the trauma of those who have had bad experiences. Transparency needs to inform a model of bodily autonomy and consent. There’s a lot that can be done without necessarily changing the establishment, but ensuring your medical practice is more inclusive and understanding. This presentation aims to deliver practical steps forward, based on the real experiences of intersex people, and current work of intersex advocates, to produce better healthcare outcomes for intersex patients.
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