Some young people with intersex variations also identify as LGBTQ+, and some do not.
Regardless, their experience in mental health settings is influenced by social, legal, and medical stigma and discrimination.
To help clinicians understand these intersections, this section has been written with people with intersex variations who identify as LGBTQ+.
Intersex rights
In NSW and throughout Australia, current medical protocols allow for unnecessary medical procedures designed to make the bodies of people with intersex variations more typically ‘female’ or ‘male’. These medical interventions are justified by the belief that they will minimise family concern and distress, and mitigate the risks of stigmatisation and gender-identity confusion.1
Many families and young people are not informed about the nature of their variation, and are told that medical procedures are required.2 Procedures often take place before children can consent, and children and families are not provided with information about the long-term health impacts of the intervention.
Consequences of early and unnecessary medical procedures can include:
- loss of autonomy and loss of choice2,3
- loss of sexual function and sensation
- loss of fertility
- urinary tract issues, including incontinence
- a need for ongoing medical treatment and/or repeat surgeries
- incorrect gender assignment.
Non-consensual interventions have been widely described as human rights violations by intersex advocates as well as the Australian Human Rights Commission.2 There are no laws or safeguards in NSW (or most of Australia, except the ACT) to advocate for the rights of people with intersex variations.
The Darlington Statement is a joint consensus statement by Australian and Aotearoa New Zealand intersex organisations and independent advocates.4 It calls for intersex rights and awareness in the areas of:
- human rights and legal reform
- health and wellbeing
- peer support, allyship and education
- awareness and employment.
Experiences of young people with intersex variations
Young people may be less likely to disclose or explore the mental health impacts of living with an intersex variation, due to social stigma, tokenisation and erasure of their experiences, as well as medical curiosity and abuse.
Taking these experiences into account is important to build trust and provide trauma-informed care. For example, for a person with an intersex variation undergoing hormone replacement therapy, consider the context and impact of past health discrimination and their sense of bodily autonomy.
Some intersex variations lead to lower fertility or infertility, and often people only become aware their fertility is affected during puberty.
Negative experiences include:
- lack of understanding, acceptance or affirmation
- social exclusion and discrimination due to misconceptions
- tokenism and lack of social acceptance, e.g: “When I tell people I’m ‘intersex’ sometimes they say ‘yeah I'm into sex as well’ and it’s like yeah, that’s not funny.”
- use of the derogatory and stigmatising term ‘hermaphrodite’
- blaming the young person’s family for their variation
- erasure of the experiences of young people and their families perpetuated by limited ideas of what bodies should be
- feeling objectified and treated like a ‘guinea pig’ as a result of medical interventions3, e.g. their body being photographed without consent, involving non-essential staff in appointments and procedures because their body is being treated as a case study
- lack of respect for bodily autonomy when a clinician wants to examine a person’s body or intervene in some way for no medical reason – due to the power imbalance between a clinician and a young person, young people often feel like they have to do what the clinician says
- internalised shame for not aligning with societal body or life milestone expectations, e.g. having biological children
- mental health distress, social isolation and stigma for those people with intersex variations affected by infertility
- legal and medical discrimination, including being denied access to their medical records.
For a lot of people with intersex variations, a doctor says: “We need to do that, or I need to look at this”. There’s white coat syndrome: the doctor knows best, there’s that power imbalance. Just to know that you have the right to your own body and bodily autonomy is really important.
Experiences of young people with intersex variations who are LGBTQ+
Many people with intersex variations identify as cisgender and heterosexual, and do not see themselves as part of LGBTQ+ communities. An Australian study about sexuality and people with intersex variations published in 20165 found that:
- 48% of the 272 respondents identified as heterosexual
- more than a third of people used multiple labels to define their sexuality
- 10% identified as asexual
- 10% prefer no label.
Due to stigma and discrimination, there is limited research or information about the experience of people with intersex variations in NSW. However, people with intersecting identities of being LGBTQ+ and intersex experience stigma and discrimination in multiple ways, both in mainstream and LGBTQ+ spaces.6
Young people who identify as LGBTQ+ and live with an innate variation have intersecting experiences of discrimination. For example, someone who is trans may have their identity questioned because they also have an intersex variation. Similarly, cisgender LGBTQ+ people may be labelled as trans because of their intersex variations. An intersex variation is not a gender or a sex.7
Both LGBTQ+ people and those with intersex variations can struggle to find medical care that is respectful of their unique needs, and this can be further increased for people with both these intersecting identities.
People with an intersex variation who are also LGBTQ+ often experience misunderstanding and erasure due to their intersecting identities. Their intersex identity and experience may be seen as part of the LGBTQ+ experience, rather than a separate aspect of their identity.
Resources
InterAction for Health and Human Rights
Intersex Human Rights Australia and Intersex Peer Support Australia recently combined as InterAction. The organisation promotes the health, human rights, self-determination and bodily autonomy of intersex people in Australia, and provides peer support and advocacy. Also publishes an Inclusion guide to respecting people with intersex variations and standardised training as part of the Yellow Tick program.
Interlink
Mental health and wellbeing services for people with intersex variations and their families, including individual and group counselling services.
I’m intersex: Here’s what that means
Young person with an intersex variation explores their experience and addresses negative and stigmatised perspectives on being intersex.
Supporting your intersex child
A guide for parents and communities on how to best support children with an intersex variation from the Organisation Intersex International Europe.
You can't ask that: Intersex (ABC TV)
Eight individuals reveal the complexities of being born with an intersex variation.
Finding pride in Australia: Steph's story
Steph is a Canberra-based intersex human rights advocate. Through their role as the founder of YOUth&I and their regular advocacy work, Steph aims to bring attention to medical interventions for people with intersex variations. This is a story focused on education, destigmatising and the human right to bodily autonomy.
References
- InterAction for Health and Human Rights. Bioethicists and paediatric surgeons debate intersex medical interventions. The Channon, NSW: InterAction; July 2020 [updated 2022; cited Sept 2024].
- Frommer M, Howell J et al. Ensuring health and bodily integrity: towards a human rights approach for people born with variations in sex characteristics. Sydney, NSW: Australian Human Rights Commission; Oct 2021.
- Equality Australia. Intersex human rights. Sydney, NSW: Equality Australia [cited Sept 2024].
- InterAction for Health and Human Rights. Darlington Statement. The Channon, NSW: InterAction; 2017 [cited Sept 2024].
- InterAction for Health and Human Rights. Intersex: Stories and Statistics from Australia The Channon, NSW: InterAction; 2016 [cited Sept 2024].
- InterAction for Health and Human Rights. Intersex: intersectionalities with lesbian and gay people. The Channon, NSW: InterAction; Feb 2012 [updated 2020; cited Sept 2024].
- InterAction for Health and Human Rights. Intersex: Intersectionalities with gender diverse people. The Channon, NSW: InterAction; June 2011 [updated Feb 2020; cited Sept 2024].