As intactivists, many of us focus on INDIVIDUAL CHOICE. Surgeries on infants and children are performed with the justification that their parents chose it for them, and that it is for some reason important for their genitals to look a certain way to "fit in" with the rest of society. For males, in a country like the US the perception is that it is the norm and a male who is not genitally altered will be teased, will not be able to find a sexual partner, and will experience physical problems like infections. In countries that practice female circumcision or FGM similar reasons are given for cutting infants and young girls.
What tends to be overlooked is that circumcision is not the only type of genital cutting that damages individuals and is often done without their consent by medical professionals before they are old enough to consent.
To be intersex essentially means that an individual has intermediate or atypical combination of physical features that usually differentiate between female or male. It is a normal variation present in humans. There are currently approximately 30,000 intersex people living in Britain, affecting approximately 1 in 2,000 live births. However, the recommendation of many doctors to parents of an intersex infant is to surgically alter the child to more match one sex or the other, on the grounds that later in life they may be stigmatised by not looking the way society says they should. (Sound familiar, intactivists?)
Many subscribe to the System of Belief theory which states that there are only females and males, only men and women, that all men have the XY karyotype, that all women have the XX karyotype, and that nothing else exists outside, despite human biology contradicting this.
Just as with circumcision, sometimes the baby grows up and later regrets the decision that was made for them to assign them to one gender or another. For example Adele Addams was assigned male at birth, due to Kleinfelter's Syndrome where the individual has an XXY chromosomal configuration. She lived as a gay man for several years, and now identifies as a female, eventually undergoing surgery under the NHS. Addams moved onto create Project Silverfish, a support service for intersex and transgender people, describing them as “the most marginalised minority community in London”
The person that really opened my eyes to the issues intersex people face was Penny Sautereau-Fife, whose blog is here. Born with ambiguous genitalia, namely an underdeveloped vaginal opening within a small scrotum, which was surgically cauterized and her family advised to raise her as a male. This felt wrong to Penny for many years and eventually discovered through some medical testing that she was in fact biologically female, possessing a uterus and an ovary but also a penis and a testicle. She has monthly periods but due to having no vaginal opening the blood has nowhere to go which causes her pain every month. Unfortunately for Penny she has a progressive genetic blood disorder which makes it life threatening to have further genital surgery to relieve this. Had she discovered her intersex status as little as 5 years earlier she could have been safely operated on but by this time it was too late for her to be able to survive the surgery.
A British study of intersex people who electively chose to have surgery to "correct" their condition as adults showed a large majority were unhappy with the results, with many experiencing diminished sexual response and physical pain. I can only imagine how much worse that would feel if the surgery were forced upon them when they were too young to consent to it.
What are the risks and consequences of intersex surgery? It is performed essentially for social reasons, yet has measurable drawbacks and risks. In many cases it leads to infertility where gonads are removed, and in 20-30% of cases sexual sensation is diminished. I think the reason people seem to think this is justified with intersex individuals is that it is seen as a birth defect, a disorder. Yet to think this way is to erase the identity of people that are happy with their status and bodies, and do not wish to conform with a forced gender binary. The OII (Organisation Intersex International) in their policy statement on genital cutting points out that there is no evidence that being intersex has any negative effect on quality of life or that surgery is any kind of solution to this. It is true that there are health risks for a small percentage of intersex people (usually mentioned is the risk of future cancer if internal testes are left inside the body) but still the vast majority of surgeries are performed for no other reason than social conformity. In the case of internal testes testing can be done later in life and surgery carried out only when necessary or when the patient chooses.
My own thoughts are that as intactivists, our focus should be on stopping ALL genital cutting of non consenting individuals where there is no medical need. Fitting in with society is NOT a medical or legitimate need. Let people decide when they are old enough how they want their genitals to look and function. To quote the OII:
Because infants and children are too young to assert their autonomy, they should not be subjected to unnecessary surgeries which may irrevocably harm them, and which they may not have chosen as adults. We recognise that cases requiring medical treatment for the maintenance of health or preservation of life should be managed as with any other situation where a child needs treatment.