their sex,’ leaving them with permanent, irre-
versible infertility and causing severe mental 
suffering.’’. 
(B) The United Nations High Commis-
sioner for Human Rights explained in 2015, 
‘‘medically unnecessary surgeries and other 
invasive treatment of intersex babies and chil-
dren . . . are rarely discussed and even more 
rarely investigated or prosecuted. . . . The re-
sult is impunity for the perpetrators; lack of 
remedy for victims; and a gap between legisla-
tion and the lived realities of intersex people.’’. 
(C) The World Health Organization ex-
plained in 2015, that children with variations in 
their physical sex characteristics have been 
‘‘subjected to medically unnecessary, often irre-
versible, interventions that may have lifelong 
consequences for their physical and mental 
health, including irreversible termination of all 
or some of their reproductive and sexual capac-
ity. . . . Human rights bodies and ethical and 
health professional organizations have rec-
ommended that free and informed consent 
should be ensured in medical interventions for 
people with intersex conditions, including full 
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information, orally and in writing, on the sug-
gested treatment, its justification and alter-
natives.’’. 
(D) Physicians for Human Rights has 
‘‘call[ed] for an end to all medically unneces-
sary surgical procedures on intersex children 
before they are able to give meaningful consent 
to such surgeries.’’. 
(E) Human Rights Watch concluded that 
these surgeries are ‘‘often catastrophic, the sup-
posed benefits are largely unproven, and there 
are generally no urgent health considerations at 
stake. Procedures that could be delayed until 
intersex children are old enough to decide 
whether they want them are instead performed 
on infants who then have to live with the con-
sequences for a lifetime.’’. 
(7) Intersex advocacy groups led by individuals 
with variations in their physical sex characteristics 
themselves advocate for the postponing or banning 
of these surgeries, as follows: 
(A) Those subjected to surgery to alter 
their variations in sex characteristics at a 
young age express despair over the fact that 
they were unable to make these decisions for 
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themselves, publishing about their experiences 
in major news outlets: ‘‘I know firsthand the 
devastating impact [these surgeries] can have, 
not just on our bodies but on our souls. We are 
erased before we can even tell our doctors who 
we are. Every human rights organization that 
has considered the practice has condemned it, 
some even to the point of recognizing it as akin 
to torture.’’. 
(B) Young people born with variations in 
their physical sex characteristics who have been 
able to participate in these life-altering deci-
sions are thriving, such as a young California 
resident with variation of sex characteristics 
who was not forced to undergo surgery in in-
fancy and instead participated in the decision at 
the age of 16. They told reporters that for 
them, surgery ‘‘was the right choice, but that’s 
very much an anomaly for intersex people. . . . 
The important thing was that I was old enough 
to make that decision for myself.’’. 
(8) The United States Department of State has 
acknowledged Intersex Awareness Day in both 2016 
and 2017 by recognizing the harm of these sur-
geries. In both years the Department released state-
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ments recognizing that ‘‘at a young age, intersex 
persons routinely face forced medical surgeries with-
out free or informed consent. These interventions 
jeopardize their physical integrity and ability to live 
freely.’’. 
(9) In light of ongoing advocacy by the intersex 
community, in 2005 the San Francisco Human 
Rights Commission performed an investigation into 
this topic and issued an in-depth report, recom-
mending that ‘‘ ‘normalizing’ interventions should 
not occur in infancy or childhood. Any procedures 
that are not medically necessary should not be per-
formed unless the patient gives their legal consent.’’. 
(10) Physicians who have participated in these 
surgeries have also expressed remorse that their 
training did not properly prepare them to respect 
the bodily autonomy of people born with variations 
in their physical sex characteristics. As a Stanford- 
educated urologist explains: ‘‘I know intersex women 
who have never experienced orgasm because clitoral 
surgery destroyed their sensation; men who under-
went a dozen penile surgeries before they even hit 
puberty; people who had false vaginas created that 
scarred and led to a lifetime of pain during inter-
course . . . the psychological damage caused by 
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intervention is just as staggering, as evidenced by 
generations of intersex adults dealing with post-trau-
matic stress disorder, problems with intimacy and 
severe depression. Some were even surgically as-
signed a gender at birth, only to grow up identifying 
with the opposite gender.’’. 
(11) When the physical health of an infant born 
with variations in their physical sex characteristics is 
threatened and medical attention cannot be safely 
deferred, all therapeutic treatment options should re-
main available to children, families, and medical pro-
fessionals to ensure that the imminent physical dan-
ger is addressed. 
(12) The United States should serve as a model 
of competent and ethical medical care and has a 
compelling interest in protecting the physical and 
psychological well-being of children, including those 
born with variations in their physical sex character-
istics. 
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