I am not Intersex (to my knowledge) but in the matter of basic bio-ethics and human rights these are not complex or difficult issues.
This post is prompted by this article http://www.healthcanal.com/surgery-rehabilitation/9595-Study-recommends-that-parents-physicians-share-decisions-sex-development-disorder-surgery.html but this is not the first time i have spoken on this issue.
It really is astonishingly simple. Children are not property. Property you can do whatever you want with. Children you cannot. You may have rights over property as an extension of yourself, but a child is not property.
A child is a person. A person in a state of effectively temporarily suspended personal responsibility. Like someone in a coma, someone who is drunk, someone otherwise not currently capable of making decisions for themselves you have a responsibility to their well being so that when they sober or wake up or are cured or grow old enough they can make their own choices. Hear that doctors? Parents?
You are obligated to ensure they can make those choices. You are obligated to their needs untill they can make their own choices. You cannot do whatever you want to them. You cannot have sex with the person in the coma, you cannot tattoo the person who is drunk. You cannot impose over them that they be how you would prefer they be or think they should want. If you think Susie would look better blonde you cannot dye her hair while she is sleeping. You aren’t there to impose your choices over them but to maximise their capacity to make choices for themselves and to maximise the choices they can make for themselves.
Those are their choices to make. And it doesn’t matter that they are presently unable to make those choices. You just have to look after them untill they are capable. So that they will be capable. You keep the comatose person fed intravenously, you hold the drunk persons hair out of the way while they vomit and be sure they don’t fall into the toilet and drown, you feed and clothe the child and ensure they get an education allowing them to make informed decisions.
This is really quite simple on a day to day basis. Now at times a decision must be made on behalf of someone who is your responsibility, in such an emergency it’s quite simple still, the decision you must prioritise is the one that maximises the latter choice of the person in your care.
So lets see how that works for childrens genitals. Well clearly you don’t have sex with children for starters.
But if you are not having sex with your child, as i found myself explaining to one woman during the Australian Human Rights Community Consultation, then your preferance in appearance of a circumcised penis has no bearing. The mother does not know what the preferance in penis appearance of that childs future partners if any will be. It’s not her bussiness.
The child is totally capable when they grow up to decide whether they want to be circumcised or not. They do not need that decision made for them before they are equally able to make their own decisions about being sexually active.
Imagine if a parent wanted their child tattoo’d. What if that child didn’t like that tattoo when they grew up?
A child may obviously come to regret having their body changed to suit the tastes of their parent/s. A choice made for them when they couldn’t decide for themselves and which in an adult is no-one elses choice but their own. So thats wrong.
Even when such body modification is religious or cultural in origin an adult has the right to change religions, to embrace them, to abandon a culture or embrace it. And so a child should not be put through such body-modifications which they later in life may regret was done to them before they can make those choices for themselves. It’s simple and beyond that it’s concrete. Anything else is an abuse of that childs rights. A failure of the parents responsibility to their child as a free decision making autonomous individual. The child can always choose to undergo that ritual circumcision, scarification, tatttooing, or any other cultural or religious practice when they are old enough to do so of their own free will. A child is a person and not property.
And so we come to Intersex Infants. And by now i already have a water-tight case of what is right and what is wrong. That which maximises the childs adult choices = right. That which reduces them = wrong. So where for survivals sake a child needs surgery the minimum required is all that may ethically be done before the child is considered capable of deciding for itself. Thats it. Nothing else is ethical.
Elective surgery on Intersex Infants is not Ethical. It should be imediately banned. Made a serious crime in fact. Circumcision on infants too should be illegal, whether on females or males, and for the exact same reasons.
Your childrens genitals are not your property. A child is a person. And a doctors duties are not to a parents wishes or preferances but to the childs future options. Thats all there is to it.
And when you understand these basic principles it becomes clear that availability of hormone blockers to delay puberty for Transgender children are quite appropriate because that action maximises the childs own choice in exactly the same way that the innaction of not surgically altering an intersex person without their consent also maximises their choices.
So while one is action and the other inaction the very same Human Rights Principle requires of Parents and Doctors a clear course of action.
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