Intersex people: Neither woman nor man

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Associations call for a ban on intersexual children

Many expectant parents are very excited when they are first informed in the gynecologist's office whether they are going to have a boy or a girl. However, this cannot always be answered with certainty. Approximately one in 4500 babies are born with ambiguous sex. These children are referred to as intersex children. With them there is a difference between the internal sex organs and the outer ones.

A person born with male XY chromosomes can be a woman on the outside, and someone with female chromosome set XX can look more like a man. A kind of mixed or intermediate form of testicles and ovaries or clitoris and penis can also occur.

Intersexuality The German Ethics Council defines the term as follows: Intersexuals are people who cannot be clearly classified as male or female due to their physical characteristics.

Starting in November, parents have the option of leaving the entry in the birth register open if their child was born intersex. So far, a male or female assignment had to take place. "A step in the right direction," says Lucie Veith, chair of the Federal Association of Intersexual People. However, this can also be a disadvantage if it discriminates against children at school, and intersex clubs go one step further and call for a ban on surgery that removes gender from affected children. Because this is usually determined by the parents or doctors. From a medical point of view, the operations are almost never necessary, says Veith. "This violates the right to physical integrity." Activists from even speak of "mutilating cosmetic genital surgery on children", which must be prevented urgently.

Stopping unnecessary interventions Many of today's intersexuals have had to endure painful and traumatic treatments in childhood, and yet the controversial interventions are common practice. Children who are to be made into a girl are put on a vaginal plastic. This is a surgically created vagina. In order to prevent an overgrowth, a foreign body must be inserted regularly. In technical jargon this means "bougien"

"I've heard from many who experienced it as a regular sexual assault," says Veith. The aim is that the operated on can have vaginal intercourse with a man. It is also questionable why they should be adapted to a gender at all and why those affected should not ultimately be able to determine this themselves if they have reached sexual maturity. "Interventions that are not medically necessary should be prohibited before the age of 16," says Veith

"With the endeavor to produce clear bodies, the child may be put on something that they don't want," says sexologist Hertha Richter-Appelt from the University Medical Center Hamburg-Eppendorf. In fairness, one has to say that not all people who underwent surgery as children are later unhappy. But an operated child can later accuse the parents "Why did you just operate on me?" And a non-operated "Why didn't you just ...?". "When it comes to clearly determining what is really better for the children, we have to let's be honest and say: we often don't know exactly, "says Richter-Appelt. She recommends waiting until puberty with gender-sensitive interventions.

New guidelines must be in place Often, girls also have what is known as adrenogenital syndrome (AGS). With them, a metabolic disorder produces more male sex hormones during embryonic development. This then leads to many girls being born with an enlarged clitoris that looks like a small penis. Surgical miniaturization can reduce sexual sensitivity, but this is rare with modern surgical methods, says Krege, a doctor at Maria-Hilf Hospital in Krefeld. She only carries out interventions on babies when parents do not want to be dissuaded from it. She advises all affected parents to wait and see how the child develops. She only offers vaginal plastic surgery to girls when they appear mature enough to do the “bougie” themselves. Many intersexual children used to remove testicles in the body cavity. The children then have to take lifelong hormone replacement therapy. This is also more of a wait, says Krege, unless it increases the risk of cancer significantly. The intersex associations are still operated on too much and too early. For Lucie Veith, it's not just about when, but also whether the operations are actually necessary. "Even as an intersexual you can be a happy person." (Fr)

Image: Lothar Wandtner /

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