The child rights agency for India’s capital city this week recommended a ban on medically unnecessary “normalizing” surgeries on children born with intersex variations. This follows the southern state of Tamil Nadu banning such operations in 2019 after a court upheld the informed consent rights for intersex children.
“Intersex,” sometimes called “differences of sex development,” refers to the estimated 1.7 percent of people born with sex characteristics, such as chromosomes, gonads, or genitals, that differ from social expectations of female or male. Except in very rare cases when the child cannot urinate or internal organs are exposed, these are medically benign natural variations of human anatomy, and do not require surgery.
In the 1960s, doctors in the United States popularized “normalizing” cosmetic operations on intersex children, such as procedures to reduce the size of the clitoris, which can result in scarring, sterilization, and psychological trauma. These surgeries became common globally, but consensus is shifting. United Nations human rights treaty bodies have condemned the operations more than 50 times since 2011.
For decades, intersex advocates around the world have asked governments and the medical community to develop standards to defer surgical procedures on intersex children until they are old enough to consent. In most countries, doctors only need parental consent to perform these surgeries. But while some medical organizations and individual physicians have supported the rights of intersex people to decide for themselves, others have largely been unwilling to engage on the issue.
During the Delhi Child Rights Commission’s consultation process late last year, the Delhi Medical Council supported the rights of intersex children. The council wrote that it “agrees with the complainants that Differences of Sex Developments/Intersex (DSD) issues are [a] human rights issue as it pertains to bodily integrity and autonomy,” and “[s]urgical interventions and gender-related medical interventions for DSD that are not deemed medically necessary should be delayed until the patient can provide meaningful informed consent.”
The mandate is now on the Delhi municipal government to formulate a policy regulating these surgeries. As the commission affirmed, everyone has the right to informed consent – even those born with bodies that are slightly different.