A controversial bill by Sen. Scott Wiener (D-San Francisco) would prohibit a doctor from performing medical treatment or intervention on the sex characteristics of an intersex minor without the informed consent of the intersex minor. Except the “minor” who would be providing “informed consent” is usually an infant or toddler.
Some people are born with variations in their biological sex characteristics, sometimes referred to as intersex traits.
What does this mean? Wiener claims “approximately 1-2% of people are born with variations in their biological sex characteristics, sometimes referred to as intersex traits,” and that the corrective surgery amounts to gender assignment surgery “before a child has had the chance to develop their sex or gender identity.”
In a resolution last year testing the waters of this controversial subject, Wiener authored SCR 110 which said, “Declares that the Legislature considers intersex children a part of the fabric of our state’s diversity to be celebrated rather than an aberration to be corrected.”
According to the American Medical Association, SB 201 is legislation that would impose a blanket prohibition on early interventions related to “differences of sex development” (DSD) without a minor’s informed consent.
At a hearing Monday in the Senate Business, Professions and Economic Development Committee, Sen. Wiener presented SB 201. Wiener said, “these are dangerous medical procedures with, in many cases, largely psychosocial benefits that cannot be considered in the context of an infant, who has yet to develop their sex or gender identity.”
“The bill requires the physician to provide written and oral disclosure to the intersex minor that contains specified information in nontechnical terms prior to performing the procedure or intervention on the intersex minor,” the bill analysis states.
The opposition testimony by physicians was compelling and science based. The supporters offered emotional outbursts, dismissing opponents’ testimony claiming they were homophobic – including the doctor Wiener brought in as his support witness.
However, this bill is also about parental rights. Wiener’s SB 201 is the latest attempt by the government to direct parents how to raise their children. According to the California Urological Association, the American Association of Clinical Urologists, the American Urological Association, and the Societies for Pediatric Urology, “Senate Bill 201 (Wiener) is an overreaching effort to limit patient and parental rights by inserting staggering government limitations into the sanctity of the patient‐parent‐physician relationship and the practice of medicine. We object to the limitation of access to medical information and medical options that are not based on scientific information. We respect a parent’s right to be involved in their child’s growth, development and medical care. Calling for limits to their role, as well as treatment options, sets a dangerous precedent.”
Wiener’s 2018 SCR 110, a resolution “to condemn unnecessary surgeries on intersex children,” said, “This resolution calls upon the medical community to discontinue these medically unnecessary, nonconsensual, and often irreparably harmful sex assignment and genital ‘normalization’ surgeries and to ensure instead that these surgeries are performed only when the intersex person has provided informed consent.”
Hans Lindahl, the communications director for interACT, a nonprofit advocating for the rights of children born with intersex traits, has testified on both of Wiener’s bills. “As the sole member of the organization based in California, she’s been a key figure in the fight to pass SCR-110,” an article in Blade reported last year. However, Blade described Wiener’s resolution differently: “In February, interACT, Equality California and Sen. Scott Wiener introduced SCR-110 — a resolution to acknowledge and celebrate intersex people.”
Many predicted the resolution was just the precursor to actual legislation, to allow the state to override parents and doctors in the treatment of this unusual and rare condition.
Wiener claimed the medical community was performing nonconsensual medical procedures that try to cosmetically “normalize” variations in intersex children’s sex characteristics. But that’s not how doctors and parents see this.
The American Association for Clinical Urologists, American Urological Association, CARES Foundation, Pediatric Endocrine Society, and Societies for Pediatric Urology jointly responded: “On behalf of the organizations listed below, we are writing to respectfully OPPOSE SCR 110 (Wiener) because it ignores scientific evidence, improvements in medical practice, and modern social understanding, and it fails to distinguish among complex medical conditions that contribute to variations in sex characteristics.”
Parents and doctors say Congenital Adrenal Hyperplasia (CAH) is a rare and life threatening genetic disease and genetic adrenal gland disorder affecting the body’s ability to regulate blood pressure, blood sugar and infection response, as well as the production of several vital hormones that are necessary for life.
And doctors say the answer is not a blanket solution — banning surgery — “to what consists of a wide variety of conditions.”
Dr. Aseem R. Shukla, a urologist at Children’s Hospital of Philadelphia, recently wrote an op ed addressing this surgery ban for the Hartford Courant, and said identical proposed legislation in Connecticut “would not only threaten the care of children with intersex conditions by denying access to surgery by erroneously deeming it ‘unnecessary,’ but it would even deny surgery to infants and children without intersex conditions who would inadvertently be placed under the purview of this legislation.”
Shukla said congenital adrenal hyperplasia CAH “is a potentially life-threatening endocrine disorder that is also the most common cause for a diagnosis of atypical genitalia. The vast majority of children who mature with CAH never question their gender, and the overwhelming majority of patients approve of having had surgery in their infancy.”
In a recent article in Curve, the headline reads: “’I’ is often added to our community’s acronym of LGBTQI, but what is it, what causes it, and how is it related to sexual preference? A lesbian shared her experience of Congenital Adrenal Hyperplasia and genital surgery:”
Because of CAH, I also knew my vagina was a little different than other females. I knew this because I had two genital surgeries when I was a kid. Two surgeries, I am glad I had. Two surgeries, that opened my vaginal canal and allowed me to menstruate without the risk of pain or infection. Two surgeries that were for function not appearance.
As of late, there has been a growing discussion concerning children born with conditions classified as Differences in Sex Development (DSD). The discussion has turned into a movement to ban genital surgery until a child is old enough to decide for themselves. On the surface, this seems very straight forward. I agree, parents or doctors should not be electing genital surgery purely for cosmetic reasons. And yes, many people have been hurt by early genital surgery. But because the movement is not being led by CAH individuals there are many facts regarding my condition that have been purposefully left out. Facts, that I believe bring context to what CAH is and its relation to genital surgery.
The writer disputes the notion that parents elect the surgery as a cosmetic option to make sure their child grows up to identify as a girl. “From my own experience and from speaking with many CAH individuals this is simply not the case. My parents never forced me to be a girl. They couldn’t care less what gender identity or sexual orientation I identified with, as long as I was healthy. And this is still the case for me today.”
Dina Matos of the CARES Foundation added: “With all patients, but especially for young people, it is paramount that doctors are afforded the right to provide parents all the possibilities, options, risks, and consequences of healthcare decisions. The current debate in California is an attempt to strip away the rights of parents to make medical decisions that are best for their children.”
CARES Foundation leads in the effort to improve the lives of the Congenital Adrenal Hyperplasia community and seeks to advance quality health care through support, advocacy, education and research.