Unacceptable behaviour

The stigmatisation of intersex people runs deep, and crops up in all sorts of ways that indicate how it is just taken for granted as normal and acceptable behaviour. It is not.

We even see some people’s words about this when they link to this site – making us complicit in their presentation of intersex traits as “bizarre” or “gone wrong”. Here are a couple of topical examples, relating to a claim that the wife of a former monarch might have had an intersex variation.

screenshot of Spivey's blog

The British royal family has weathered many storms of controversy, none greater than the obsessive romance between Edward VIII, heir to the throne, and twice-divorced American socialite Wallis Simpson which ultimately resulted in the abdication and forced exile of the charismatic King.

To add more drama to the already incredible fairy-tale gone wrong, Baltimore-born Wallis was alleged to have been born intersex – that is, born with male sex organs and genetic characteristics… (Spivey 2021)

The source for this blogger’s remarks – the one that includes that remark about a “fairy-tale gone wrong” is an Australian women’s magazine, New Idea:

screenshot of New Idea article by Alice Murphy

The bizarre royal family sex rumour that won’t go away
The most scandalous secret of all – by Alice Murphy
[..]
To add more drama to the already incredible fairy-tale gone wrong, Baltimore-born Wallis was alleged to have been born intersex – that is, born with male sex organs and genetic characteristics (Murphy 2019)

These people seem to think there are no consequences to their words, but we see them.

We regularly remark on the role that body shaming plays in medical decision-making about surgeries and hormonal interventions on infants and children with intersex variations. This underlying stigmatisation too plays a role – and Mikayla Cahill clearly expressed this recently when talking about how clinicians think that their tools fix this problem:

“Doctors usually tell us not to tell anyone because they won’t understand because everyone in school is taught there is only female and male, XX or XY,” Mikayla says. “They don’t want us to be ridiculed.” (Madden-Smith 2021)

In 2006 a clinical “consensus” statement that reframed intersex traits as “disorders of sex development” reported that unevidenced feelings and beliefs about surgery justified medical intervention to modify genital appearance, where “satisfactory outcomes” are cosmetic:

Rationale for early reconstruction includes beneficial effects of estrogen on infant tissues, avoiding complications from anatomic anomalies, satisfactory outcomes, minimizing family concern and distress, and mitigating the risks of stigmatization and gender-identity confusion of atypical genital appearance (Houk et al. 2006)

It is generally felt that surgery that is carried out for cosmetic reasons in the first year of life relieves parental distress and improves attachment between the child and the parents. The systematic evidence for this belief is lacking (Hughes et al. 2006)

While the 2006 consensus statement served more to underpin preexisting medical practices than change them, so lack of evidence remains a problem today, according to a 2016 clinical update:

There is still no consensual attitude regarding indications, timing, procedure and evaluation of outcome of DSD surgery. The levels of evidence of responses given by the experts are low […]

Timing, choice of the individual and irreversibility of surgical procedures are sources of concerns. There is no evidence regarding the impact of surgically treated or non-treated DSDs during childhood for the individual, the parents, society or the risk of stigmatization

In 2013, the Australian Senate found that “there is no medical consensus around the conduct of normalizing surgery”, and such rationales are a “circular argument”:

There is frequent reference to ‘psychosocial’ reasons to conduct normalising surgery. To the extent that this refers to facilitating parental acceptance and bonding, the child’s avoidance of harassment or teasing, and the child’s body self- image, there is great danger of this being a circular argument that avoids the central issues. Those issues include reducing parental anxiety, and ensuring social awareness and acceptance of diversity such as intersex. Surgery is unlikely to be an appropriate response to these kinds of issues. (Senate 2013)

The cross-party recommendations of this inquiry have not been implemented by any Australian government.

It is ok to be intersex. We have a vibrant and growing community. The stigmatisation of intersex traits is a problem and we need your help to end it.

More information

Carpenter, Morgan. 2016. ‘Body Shaming Is an Intersex Issue – Intersex Human Rights Australia’. August 19. https://ihra.org.au/30697/body-shaming-intersex-issue/.

Houk, C. P., I. A. Hughes, S. F. Ahmed, P. A. Lee, and Writing Committee for the International Intersex Consensus Conference Participants. 2006. ‘Summary of Consensus Statement on Intersex Disorders and Their Management’. Pediatrics 118 (2): 753–57. doi:10.1542/peds.2006-0737.

Hughes, I A, C Houk, S F Ahmed, P A Lee, and LWPES/ESPE Consensus Group. 2006. ‘Consensus Statement on Management of Intersex Disorders’. Archives of Disease in Childhood 91: 554–63. doi:10.1136/adc.2006.098319.

Lee, Peter A., Anna Nordenström, Christopher P. Houk, S. Faisal Ahmed, Richard Auchus, Arlene Baratz, Katharine Baratz Dalke, et al. 2016. ‘Global Disorders of Sex Development Update since 2006: Perceptions, Approach and Care’. Hormone Research in Paediatrics 85 (3): 158–80. doi:10.1159/000442975.

Madden-Smith, Zoe. 2021. ‘I’m Intersex and I Wish Doctors Had Left My Body Alone’. Re: News, April 16. https://www.renews.co.nz/im-intersex-and-i-wish-doctors-had-left-my-body-alone/.

Murphy, Alice. 2019. ‘The Bizarre Royal Family Sex Rumour That Won’t Go Away’. New Idea Magazine, March 6. https://www.newidea.com.au/the-bizarre-royal-family-sex-rumour-that-wont-go-away.

Senate of Australia Community Affairs References Committee. 2013. Involuntary or Coerced Sterilisation of Intersex People in Australia. http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Involuntary_Sterilisation/Sec_Report/index.

Spivey, Christopher. 2021. ‘Prince Philip Remembered’. April 18. https://www.christopherspivey.co.uk/2021/04/18/prince-philip-remembered/.