Intersex "Treatment" Trauma and Sexual Abuse Trauma: Not So Different

I have been thinking about medical procedures and "treatments" intersex individuals are often forced to undergo without consent, and how they can easily be viewed as abusive. Specifically, many procedures are akin to sexual abuse.

In my own experiences, some doctor would feel compelled to check the length of my vaginal canal every time I vistited (every half-year for many years starting when I was maybe 10, and then every year until I was 14 or so). This meant that they would take a freezing-cold metal dilator, coat it with (medical?) lube or something that burned like hell (it was probably alcohol-based), and insert it into my vagina and held it for several seconds until I, of course, started to whimper, shout, tell him to stop, burst into tears, or all of the above. I did not know that I had the ability to deny consent to these vaginal-length-checks using the dilators. They were presented as a standard procedure, like listening to one's hearbeat, or opening one's mouth and saying, "Ahhhhhhhhhhhhhhh!" really awkwardly. I had no idea that these procedures did not benefit or track my health...they just tracked how likely a candidate I might be for one of several kinds of particular genital mutilation surgeries collectively called vaginoplasties, which would also not benefit or improve my health. It would only give me a reconstructed vagina, which may or may not have serious, deleterious health consequences, as I briefly detailed in a former post.

I was (and still am) outraged that these trauma happened to me and I wasn't told I had a choice as to whether I want it to happen or not. And I am still dealing with the aftermath. Sometimes, I have vivid daymares consisting of flashbacks of some of these dilation procedures, and the other stigmatizing parts of the appointments that followed before and after. It felt so dehumanizing to me, even as a young child, to have to change into the scratchy-ass nightgown, lay on the cold metal table, and live through these things done to me I so, so didn't want done. (Often, multiple times if they couldn't get a measurement the first time, after which I was berated for moving around and whining too much. Doc, you would do it, too, if you knew what that felt like.) But, as intersex individuals, we're taught not to talk about our intersex or any issues surrounding intersex with others, oftentimes preventing effective dialogue even among our closest family members and ourselves. So I didn't discuss it out loud, but I felt that these procedures were abusive. I felt really guilty about feeling this way, because I was clearly taking up space I didn't need to. I wasn't "really" abused...abuse was for individuals that were touched, prodded, and traumatized under entirely different circumstances, right? If there was an old white dude in a medical coat present, it wasn't really abuse, was it?

Emi Koyama, intersex activist and founder of Pacific Northwest's Intersex Initiative, created a booklet entitled, Introduction to Intersex: A Guide for Allies (2nd Edition). On page 2 of the booklet (or page 5 in the Adobe PDF), she explains the following:

"One of the biggest problems with this "treatment" is that it sets in motion a lifelong pattern of secrecy, isolation, shame, and confusion. Adult intersex people's stories often resemble that of those who survived childhood sexual abuse: trust violation, lack of honest communication, punishment for asking questions or telling the truth, etc. In some cases, intersex people's experiences are exactly like those of childhood sexual abuse survivors: when they surgically "create" a vagina on a child, the parent - usually the mother - is required to "dilate" the vagina with hard instruments every day for months in order to ensure that the vagina won't close off again."

I would expand on this to include forced dilation at any interval during "treatment," and not restricted to those post-mutilation surgery. This is definitely how I feel about my experiences.

Koyama continues:

"Even so, many intersex adults report that it was not necessarily the surgery that was most devastating for their self-esteem: for many, it is the repeated exposure to what we call "medical display," or the rampant where a child is stripped down to nude and placed on the bed while doctors, nurses, medical students, and others come in and out of the room, touching and prodding and laughing to each other. Children who experience this get the distinct sense that there is something terribly wrong with who they are and are deeply traumatized. "

I have not experienced this, but can easily see how being publicly ridiculed would be traumatizing, and how one's emotions while/after being touched and prodded against one's will may be akin to those of childhood sexual abuse survivors.


This post is a major bummer, but I'm not sorry, because I believe that negative feelings, when properly channeled, can be used as vehicles to initiate positive change. If you're outraged, there are lots of conversations to be had with those that don't know about intersex issues, e-mails and letters to write, lots of protests to organize, lots of petitions to create and sign, lots of books, zines, art, and music to make and support that raise awareness and try to change these medical abuses. I always must remind myself that it is okay and healthy to allow oneself to experience negative feelings, but if it just stops there after my own negative feelings have passed, will they be gone for good if the social systems and problems informing them still exist? If my own feelings are resolved for the moment, is that justification to stop fighting for others still experiencing pain and trauma? I don't think so.

Koyama states "...it is estimated that five children per day continue to undergo the medically unnecessary and irreversible surgeries in the United States." These five (plus?) children a day are worth fighting for. We just have to go out and actually do it.