The Push to Ban Intersex Medical Intervention

Lane Palmer


Urol Nurs. 2019;39(3):147-149. 

In This Article

Congenital Adrenal Hyperplasia

A paradigmatic example concerns a condition known as congenital adrenal hyperplasia (CAH), a potentially life-threatening endocrine disorder that is also the most commonly diagnosed cause of atypical genitalia. This condition consists of several autosomal recessive diseases, most of which involve either excessive or deficient production of sex steroids, which can alter the development of primary or secondary sex characteristics. Of the many possible symptoms, one of the most notable results is ambiguous or underdeveloped genitalia. Most children who mature with CAH never question their gender, and the overwhelming majority of surgery patients have approved of their surgeries (Fagerholm et al., 2010).

The medical community's treatment of CAH has been a resounding success. As many CAH-affected families have described it, the children overwhelmingly identify with their chromosomal gender, to the point where many with CAH even repudiate the label of "intersex." Furthermore, they contend that such surgeries are not gender reassignment surgeries. Rather, the procedures are aimed at restoring the functionality of the existing anatomy to allow for proper voiding and reproduction. In fact, nearly 90% of patients believe that feminizing genitoplasty procedures should be performed within the first year of life (Binet, Hubert Lardy, François-Fiquet, & Poli-Merol, 2016) – a powerful affirmation of the medical community's current practice.

Unfortunately, intersexuality has become highly politicized over the last few years. What should be treated as a medical concern and a deeply personal and private decision has become a talking point and rallying cry for activists who often lack a nuanced understanding of the issue, and generally, have an agenda beyond acting in the interests of patients. Much of the recent political discussions in our culture have centered around evolving understandings of the nuances of sex and gender, but these activists tend to compress a wide spectrum of conditions under singular labels, with singular solutions.

The simple fact is, there are no singular solutions. What has gone under the label of "intersex" encompasses such a wide variety of conditions that it is simply impossible for any principle, law, or procedure to adequately cover everything. Depending upon one's medical condition, studies have shown highly divergent responses to treatment and have come to increasingly nuanced conclusions. To speak of this wide spectrum of people as if they are a coherent group with identical interests and functional issue is to do a great disservice to the diversity and pluralism of these individuals.