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The often catastrophic results of surgery on intersex children made the American Medical Association (AMA) consider discouraging the practice.Inaddition, two groups that advocate intersex youth released a report on July 25 that warned of the possible irreversible and psychological harminflicted on children due to the rearrangement of their reproductive anatomy to resemble that of a typical boy or girl.
Although the pressure to fit in and have a normal life is real for intersex children, there is no evidence that surgeries,while the kids are still young,
would make life easier for these young people.AMA, Human Rights Watch, and InterACT want intersex children to be old enough to have a say in thedecision to undergo surgery.
The report not only hit the practice but also urged the US Congress to ban it.The opposition to the practice of intersex surgery is growinginternationally.Several UN agencies condemned the practice in 2016, while Malta banned it , the Associated Press reported.
Surgery is unjustified
To further strengthen the argument against intersex surgery for children, three former US Surgeons spoke against the practice, according to thereport.Joycelyn Elders, David Satcher, and Richard Carmona said there is not enough evidence that children who grow up with genitalia that are nottypical for their apparent physical gender leads to psychosocial distress, The New York Daily News reported.
The UN, World Health Organization, and Amnesty International had labeled some of the unnecessary intersex surgeries for children as human rightsviolation, a female urologist who eventually regretted performing intersex surgery on a teenager with complete androgen insensitivity syndrome(CAIS), said.An adolescent with CAIS has XY chromosomes, usually appear atypical female, do not have a uterus, but have testes in the abdomen.
Not all medical associations share the belief that intersex surgery, while the patients are young, is harmful.The Socieites for Pediatric Urology did notissue a statement to recommend a delay of surgery until the patient is mature enough to give informed consent.But the American Academy ofPediatrics released a statement in 2008 that suggested delay or deferment of some intersex surgery.
According to experts, one of every 2,000 babies born may have differences of sex development that may lead a doctor to recommend surgery orother forms of medical intervention.These newborns have the reproductive organs and external genitals that develop different for a typical girl orboy.The condition is relatively rare, with up to two percent of the population born with intersex traits, but the intersex variations reach up to 40,according to Kimberly Zieselman, the executive director of InterACT.
The lack of understanding leads people to discourage children born with the condition not to discuss their being intersex.It makes the intersexchildren feel different and odd which are carried over into adulthold.The kid with the condition gets the message that they are wrong and different,and they need to fix something in their anatomy, Zieselman said.
A child, when he or she is told by the society that he or she does not belong, and his or her body is a mistake , will continue to struggle with it often therest of their lives.By imposing a moratorium on fixing babies, InterACT recommended that surgeons instead focus on adolescents, young adults, andadults who have attained a certain level of maturity to decide if they want to undergo intersex surgery or not.
Opposite point of view
However, there are other advocacy groups that do not share the same point of view as AMA and the other international organizations opposed to thepractice.CARES Foundation, an organization that adocates on behalf of families with kids who have congenital adrenal hyperplasia (CAH), orabnormal genitalia, criticized the newly released report.It said that choices available to parents and patients must not be limited. "Medical decisionsare difficult enough for parents without having to contend with the moral and philosophical agendas of certain movements," CARES said in astatement.
To help families with intersex children, in some hospitals, there are specialized teams that provide advice which cover physical and psychologicalissues.At the Children's Hospital Colorado, near Denver, the medical facility created the SOAR Clinic in 2012 that offers specialists in urology, genetics, psychology, and other fields.It also has patient advocates -- intersex people who offer support based on their personal experience.
The clinic develops an individual treatment plan for every family.Parents are encouraged to participate in making crucial decisions that would forever affect the lives of their children who happen to be born with a set of reproductive organs differnt from what their genes say it should be.
Dr.Jennifer Barker, a hormonal and glandular complications expert, acknowledged that performing intersex surgery for infants and young kids is on of the most difficult decisions the SOAR Clinic team faces.A ban on the procedure would make the physicians on the team feel unduly restricted.