"'Curing Intersex Is Damaging and Common": Great Piece by OII-Australia Member, Morgan Carpenter

One of the key human rights issues for intersex people is not the existence of binary genders, but what is done medically to make them conform to those norms, writes Morgan Carpenter.

Intersex, the I in LGBTI, is often invisible, assumed to be about sexual orientation or gender identity. In fact, intersex has more to do with the body.

Intersex people are born with sex characteristics that don’t fit stereotypical expectations for males or females. There are at least 40 known intersex variations, each different, with no homogenous intersex body or identity. Some intersex variations can result in visibly ambiguous genitalia, others don’t. Diagnosis can happen any time from prenatal testing through to adulthood.

Historically, intersex people have been regarded as something “other”, sideshow freaks or medical curiosities, objects for stigmatisation and discrimination. In more recent times, people with intersex bodies have been regarded as “disordered”.

One of our key human rights issues is not really the existence of binary genders, but what is done medically to make us conform to those norms. Over the last 60 years, diagnosis has led to surgical and hormonal interventions, often in infancy or childhood. For much of that time, a diagnosis was thought so shameful it often wasn’t disclosed.

It would be easy to imagine these issues are all in the past, a legacy of previous practices. We heard Dr. Shubha Srinivasan say how practices in the past were harmful, and how she hopes things have changed. She’s right, but there’s been no attempt at reparations.

As intersex advocates and peer support workers, we hear from adults with long histories of sexual and intimacy issues caused by “obsolete” surgical methods. We hear of attempts to recover childhood medical information, and even discrimination due to overt physical differences.

Not only do people with intersex variations suffer a legacy of clinical secrecy, of shame and stigma, we also suffer trauma due to medical intervention. And even so, this is not the full story.

The Australian parliament recognised our existence in 2013, with the inclusion of “intersex status” in anti-discrimination law, and a world-first parliamentary report into intersex health, and coerced sterilisation. We’re still waiting for a government response to that report, but we know a lot about current practices because of it.

Today, the testes of women like Bonnie are no longer routinely removed before puberty. Clinicians are better at diagnosis, and more likely to recommend a sex assignment based on “likely” future gender identity than surgical ease. There’s no longer a culture of secrecy around diagnosis itself. But much hasn’t changed.

The clinical language of “disorders of sex development”, rejected by community-led organisations, ensures that an intersex pregnancy and birth is still a problem to be “fixed”.

A Senate committee heard from clinicians that infants and children with ambiguous genitalia still face early surgeries. These happen when a clitoris is deemed “too big”, or a boy can’t stand to pee.

We regularly hear from parents with newborn infants. We hear how their child might be described as healthy - except for their intersex characteristics. Parents get a prompt referral to a surgeon, and maybe a late referral to a counsellor or psych. They might get a referral to a Toronto hospital website for background information, but no referral to an Australian support group.

We’ve seen medical papers that talk of the “pros and cons” of surgery, but only detail its necessity. That necessity is often based on stigma towards intersex people. Surgeries have the dubious aims of helping parents to love their children, preventing issues with baby-sitters or bullying in the changing room, and even improving marriage prospects. Genital surgeries aim narrowly to ensure heterosexual sexual performance.

Maybe surgeries do prevent some of those problems, some of the time, but there’s no firm evidence they do. Most often, treating a healthy body as a surgical problem is itself stigmatising. I know from my own experience that it’s not a good feeling to know that your body had to be modified to be acceptable to your family, and to society.

The science supporting current medical practice is contradictory and inadequate. Australian doctors themselves told the Senate they have “particular concern” about sexual function and sensation after cosmetic genital surgeries. One Australian hospital says that outcomes from current surgeries “remain to be established”, and yet there is no long term follow-up in this country.

Our National Health and Medical Research Council has heard that intersex variations are abnormal, disordered, defects, and people with them suffer psychological trauma. $5.5 million in public funds has just been invested in genetic research and testing - but no money goes to fund peer and family support.

We can’t keep removing the stigma of cosmetic differences with a surgical knife. It comes at the cost of future sexual function and choice. The Senate report said the status quo must change, and international human rights bodies are beginning to pay attention. Non-essential surgeries must be delayed until an individual can consent for themselves. Peer support must be integrated into clinical practice.

It’s ok to be intersex. The diversity of our bodies and identities are good things. We add to the richness of human existence. As the parent in The Feed’s interview said about us, “Let them enjoy their bodies, celebrate that difference”.

Morgan Carpenter is the president of organisation Intersex International Australia, a community organisation that promotes human rights and bodily autonomy for intersex people.

CCJ Reserves Judgement In Maurice Tomlinson Immigration Case ....... No restrictions on Caricom gays, TT officials say

The Caribbean Court of Justice (CCJ) has reserved judgement in the application filed by human rights and gay rights advocate, Maurice Tomlinson, who is challenging the immigration laws of Trinidad and Tobago and Belize.

See the latest video of the actual proceedings HERE, HERE and HERE

Tomlinson is contending that the immigration laws of both countries violate his right to freedom of movement and his right not to be discriminated against on the basis of his nationality.

Tomlinson wants the CCJ to grant a declaration that the laws should be amended to remove the barring of homosexuals from entering Trinidad and Belize.

The human rights and gay rights advocate is also seeking damages.

Trinidad and Belize have opposed the application.

PORT OF SPAIN, Trinidad (Trinidad Express) — Despite there being legislation in place under local immigration laws to prevent members of the gay community from entering Trinidad and Tobago, acting Chief Immigration Officer Gerry Downes yesterday said there is policy in place to allow those individuals who are members of Caricom nations free movement in and out of this country.

There are no restrictions on those individuals simply because of their sexual orientation, but restrictions are placed on people who are not members of Caricom states and are seeking to enter Trinidad and Tobago, he said.

Downes made the statement yesterday while testifying during a hearing at the Caribbean Court of Justice (CCJ) in Port of Spain, in which Jamaican gay rights activist Maurice Tomlinson is challenging local immigration laws, which he contends are homophobic and inconsistent with Caricom policy on free movement between citizens of member states.

Questioned by Tomlinson’s attorney Douglas Mendes SC on how immigration officials may treat with the matter should his client seek to enter this country, Downes said: “If he were to come back to Trinidad we would treat him as any other Caricom national because he is a Caricom national.”

Tomlinson is challenging Section 8 of the Immigration Act, which allows immigration officials to refuse entry to homosexuals, prostitutes and other people who may benefit from the proceeds of either. He also brought action against the Government of Belize whose immigration legislation is similarly worded.

The action was brought under the Revised Treaty of Chaguaramas, which established both the CCJ and the Caribbean Single Market Economy (CSME).

As an activist for the lesbian, gay, bisexual and transsexual (LGBT) community, Tomlinson, who is also an attorney, had travelled to both countries previously, but after discovering the existence of the prohibitions he refused invitations from both countries to avoid violating their immigration laws “and he claims to have suffered prejudice thereby”.

The case of openly gay singer Elton John, who was allowed into this country to perform at a concert in Tobago in 2007, was also raised during the hearing.

Downes explained that if John was “a skilled Caricom national” he would have been allowed into this country and “that would not have been a problem”, but given he was not, John had to be granted special permission to do so.

Belize’s acting Director of Immigration, Maria Marin, also testified during the hearing. Like Downes, Marin said no members of Caricom nations are prevented from entering the country based on their sexual orientation.

She said, in 1998, a cruise ship with approximately 700 gays came to Belize and all the individuals were allowed into the country.

Presiding over the matter are CCJ president Sir Dennis Byron, Rolston Nelson, Charles Anderson, Adrian Saunders and Jacob Wit.

Attorney Imran Ali appears alongside Mendes for Tomlinson, while senior counsel Seenath Jairam, Wayne Sturge and Gerald Ramdeen are representing the Government of Trinidad and Tobago.

also see: 

UK Supreme Court dismisses Secretary of State's appeal on designated state status of Jamaica and risk to homosexuals

Mendes: Ban on gays ‘bad for T&T’

EU Parliament human rights report addresses LGBTI criminalisation, trans rights and same-sex unions worldwide

Last week, the European Parliament voted its annual report on human rights in the world. The report takes account of the situation of human rights, including of LGBTI people, and makes recommendations accordingly.

The report contains strong language on the rights of LGBTI people. Particularly, the Parliament Expresses concern that “78 countries still criminalise homosexuality, including 10 which provide for the death penalty . . . and that 20 countries still criminalise transgender identities.” 

It calls to continue raising this in dialogues with third countries, and to support organisations defending LGBTI rights;

Addresses anti-propaganda laws by welcoming the annulment of the Moldovan law, and calling on other countries to follow their example;

Calls on the Commission and WHO to act towards ending listing of trans identities as mental illnesses and to introduce quick, transparent and accessible legal gender recognition procedures based on the person’s self-determination;

Highlights that sterilisation requirements for legal gender recognition should be treated and persecuted as a breach of the right to bodily integrity and of sexual and reproductive health and rights;

Encourages the EU and Member States to “reflect on the recognition of same-sex marriage or same-sex civil union as a political, social and human and civil rights issue”

A paragraph condemning referendums limiting marriage to opposite-sex couples and highlighting negative developments in Croatia, Slovakia, Macedonia, Lithuania and Russia, was watered down from the initial draft through an amendment by the centre-right European People’s Party.

Daniele Viotti MEP, Co-President of the LGBTI Intergroup, reacted: “The EU has a key role to play in promoting and protecting human rights, which includes the rights of LGBTI people. In the debate about the report High Representative Mogherini emphasised this again, saying human rights are not a priority, but the priority of external relations of the EU.”

“The adoption of this report by a wide majority sends a clear message from MEPs to step up efforts to effectively protect all LGBTI persons’ rights.”

Isabella Adinolfi MEP, Vice-President of the Intergroup on LGBTI Rights, added: “I strongly welcome this report, which confirms that LGBTI rights are human rights.”

“Now it is key to be consistent in applying this both within the EU as well as in our outside relations.”

Read more
Read the Annual Human Rights in the World Report (particularly par. 159-165)

Pills before and after sex can help prevent HIV, another study finds

A study shows that a drug used to treat HIV infection also can help prevent it when taken before and after risky sex by gay men.

The results offer hope of a more appealing way to help prevent the disease beyond taking daily pills and using condoms, although those methods are still considered best.

The study, done in France and Canada, is the first to test "on demand" use of Truvada, a pill combining two AIDS drugs, by people planning to have risky sex. The uninfected men who took it were 86 per cent less likely to get HIV compared to men given dummy pills.

"That impressed me," Dr Scott Hammer said of the size of the benefit. He is an AIDS specialist at Columbia University in New York and heads the Retrovirus Conference going on in Seattle, where the results were discussed Tuesday.

Daily Truvada pills are used now to prevent HIV infection in people at high risk for it, and studies show the drug helps even when some doses are skipped. Health officials have been leery of billing it as a "chemical condom" out of fear that people will not use the best prevention methods, but many won't use condoms all the time or take daily pills.

The study of Gilead Science's Truvada was led by the French national HIV research agency.

Men were given fake or real Truvada and told to take two pills from two to 24 hours before sex, a third pill 24 hours later, and a fourth pill 48 hours after the first dose. The men also were given condoms and disease prevention counselling.

The study was stopped early, in November, after 400 men were enrolled and researchers saw that the drug was working; there were two new HIV infections among those on Truvada and 14 in those on dummy pills. The two infections in the Truvada group were in men who stopped using the pills after more than a year in the study.

The drug was safe, but nausea and diarrhoea were more frequent among men who used it. Only one stopped using it because of side effects.

Dr Susan Buchbinder, an AIDS specialist at the San Francisco Department of Public Health, called the results exciting but warned that it can't be assumed they would apply to male-female sex, because different types of sex expose partners to differing amounts of virus.

The US Centers for Disease Control and Prevention still recommends daily Truvada pills for prevention, and many men in the French study ended up taking them nearly that often because of how frequently they had sex, said the CDC's HIV prevention chief, Dr Jonathan Mermin.

"We need all the options we can get" for preventing HIV infection, Mermin said. "People choose different prevention methods. What we want is for them to choose effective ones and to use them regularly."

One advocate for wider use of prevention pills -- Damon Jacobs, a New York City psychotherapist -- agreed.

For years, the public health message was "condoms only, condoms only, condoms only," he said in a speech at the conference. "People are having sex for pleasure" and need alternate ways to reduce their risk, Jacobs said.

A second study presented at the conference by the UK Medical Research Council found that daily use of Truvada cut the risk of infection by 86 per cent in a "real world" test of gay men aware they were taking Truvada for HIV prevention.

Researchers assigned 545 gay men to get Truvada right away or a year later. The study was stopped in October after HIV infections occurred in only three men given Truvada but in 19 of those assigned to get it after a year.

As in the French study, rates of other sexually spread diseases were similar in both groups, leading researchers to conclude that use of the prevention pills was not increasing risky behaviour.