What falls to our share from The Intersex Forum?

What falls to our share from The Intersex Forum?

• 30/05/2021
• E. Ege Tektaş

This article is an extended version of Elif Ege Tektaş's article titled "What Happened at the Intersex Forum", published on KAOSGL on May 25th, 2021.

The Intersex Forum, held by UniKuir NGO and Inter Dayanışma (Intersex Solidarity), took place in a digital platform on Saturday, May 22. An open call was made to LGBTI+ activists, LGBTI+ rights advocacy associations, association volunteers, medical professional bodies, and medical students to participate in the forum. The following speakers took part in the Forum with their speeches, which took place between 12:00 – 16:30: “Intersex rights and legal developments” by Belgin Günay, “Medical interventions for intersex people” by Zeynep Keskin, “Intersex people in education, employment and organization” by Şerife Yurtseven, and “What falls to our share?” by Yasemin Bahar. At the beginning of each session, videos from the LGBTI+'s Questions to Intersex people series prepared by Inter Solidarity and Lamdaİstanbul LGBTI+ Solidarity Association were screened. 

Intersex rights and legal developments

In the forum's first session, Belgin Günay (they/them) talked about the current legal developments and various dimensions of intersex rights. Belgin Günay commenced their speech by touching upon how gender place in identity cards affects intersex people. Being aware that intersex children can identify with a different gender like all other children, they laid stress on the necessity of gender reorganization. They gave examples of countries where the gender marker is changed conditionally and unconditionally (only with autonomy) as well as countries having gender options other than men and women. Moreover, they talked about the demands in the Malta Declaration that gender should not be included in identity cards; they read and interpreted the Malta Declaration translated into Turkish by Inter Dayanışma. They continued their speech on the legal protections proposed for intersex individuals and the current legal violations across the world. They also mentioned abortion, sterilization, and cosmetic gonadal and genital interventions. They stated that non-consensual interventions unsettle bodily integrity and health, and this means torture and violation of rights. They underlined the harms of pathologizing intersex people legally and medically. They made explanations regarding the positive examples of the recognition and protection of intersex people before the law, especially the compensation decision in Sweden. In this context, Belgin Günay pointed out the current law that Germany adopted in March 2021, which recognizes the third gender and limits the rights of parents on the body of intersex children. They also presented various shortcomings and deficits of the law.

Belgin subsequently mentioned that Turkey has no laws covering and protecting intersex people, rather only laws that supposedly protect everyone. They stressed the need for laws to specifically address legal violations to which intersex people are exposed. To set an example of the violations, they referred to cosmetic medical interventions, violation of privacy, and sharing of genital photos. Belgin explained through examples that the ethical responsibilities of healthcare professionals in Turkey are not adequately paid regard to. Then Belgin talked about the discrimination that intersex people are exposed to in the field of competitive sports in the world, and they exampled the discrimination and struggles of the athlete Caster Semenya. To contribute to what Belgin Günay mentioned, Specialist Dr. Filiz Ak, Family Physician from the Turkish Medical Association, participated and talked about the national and international legal ethical documents binding physicians in Turkey and their deficiencies.Belgin Günay gave examples of the discrimination as a result of the lack of awareness of their colleagues and medical students on this issue.

Highlights from Belgin Günay's speech are as follows:

“Just as there may be medical problems unique to the organs called female reproductive organs and male reproductive organs, there may also be problems unique to intersex people. Being a woman is not a disease, and being intersex is not a disease either.”

“Sports authorities, incompatible with the human rights, may ask intersex athletes to reduce or increase their hormone levels or even to undergo surgery.”

“The Malta Declaration is a text that answers the question “well, what do we do, what do you want” that arises when we tell about the difficulties and our experiences; that's why it's a matter of life or death for intersex people.”

“When you share your experiences and traumas, even with your own family, you are exposed to scorning behaviour. People don't understand the damage and the impact on you when your body, which forms your basic sense of self, is 'modified' without your consent. The culture we live in has a normalizing effect. Therefore, it is necessary to create more awareness in the society on this issue.”  

You can access Belgin Günay's speech on the UniKuir Podcast: Intersex rights and legal developments

Medical interventions for intersex people

In the second session of the forum, Zeynep Keskin (she/they) talked about medical interventions for intersex people and shared her experiences. She started her speech by stating that intersex is approached by doctors as a matter of existence, a profit-loss ratio is made, and if the “harm” is high, it is seen as a disease, and then continued by stating that intersex is not an existential disease. She drew attention to the interventions that caused injury and health problems. She emphasized that reproductive disability leads it to be considered as a disease but stated that intersex people can reproduce. She expressed that there are medical conditions specific to intersex people, but these conditions do not mean that intersex people are sick on their own. Noting that it should be the intersex people themselves, not parents, doctors or norms, who draw the frame for medical interventions, she emphasized that others should not have a say about intersex people and their experiences. While sharing the experience of having a child with the in vitro fertilization / surrogate mother method in a complicated way, against the statement of “Will you be a mother or father?”, Zeynep said she had filed a criminal complaint, but because she could not access her medical records, the evidence was not deemed sufficient and the investigation was not allowed. She highlighted the lack of adequate enforcement and legislation in this field that provides a safe space for intersex people.

Zeynep stated that the source of the mental problems that intersex people experience is the society's approach to intersex people and social norms, rather than being intersex solely. Noting that approaches to intersex children differ in urban and rural areas, she emphasized that there should be intense and deterrent sanctions against medical interventions, violations of rights and discrimination against intersex people. 

Later in her speech, she made the following suggestions: bringing medical ethics up for discussion, raising awareness of physicians against violations of rights, opening this issue up for discussion within professional organizations, and questioning social norms. The importance of the medical and mental health specialists was emphasized to raise awareness and guide families in the right way. Zeynep pointed out that since every child needs protection, support should be provided to intersex children in the field of education and health, and that this support and protection should be perceived as a protection against the binary gender system for intersex children. As for intersex people and intersex self-organization, Zeynep talked about the need to create a safe social space where they can talk and share their experiences without compromising their personal safety and said that otherwise, withdrawing into the shell may cause everyone other than intersex people to speak for them. In the question and answer part, the remedies to create a safe space in health services for intersex people were discussed with the contributions of the participants.

Highlights from Zeynep Keskin's speech are as follows: 

“At the end of the day, we see that more desperate situations arise as a result of the interventions that the medical doctors define as a disease, up to the mutilation they have done. We are content with our life in a place where they do not have such interference.”

“I never consider myself sick. Let's suppose that it's a disease: there's nothing I can do, it's not a crime! Something out of my control. So even if it is a disease, it would be nonsense to be excluded because of it. This is fascism and unfortunately this fascism continues in medicine.” 

“Since I spent my childhood years in urban life, I encountered different approaches. As far as I understand, there is a more difficult situation in the countryside. The people living in the cities think a little more “this is possible”, but they still wish it would not happen and they exclude it.”

“When I wanted to be a foster family and when I wanted to freeze my undifferentiated gonads, the Endocrinology doctor asked, "Will you be the mother or the father?" It would be better if we could look at the issue in terms of being a parent, not being a mother or a father. It was something that deeply affected me. Since he did not share my patient file with me, I wanted to claim against the doctor just after the operation, in which my gonads were removed - according to me, it was deformed - but the hospital did not give permission for an investigation. I brought it to the administrative trial. I applied to CIMER (Republic of Turkey Presidential Communication Centre)[1] and there was no response; Now I'm thinking of making a new application about CIMER's non-return.”

“Unfortunately (when I was 16), when I got on the hook and got examined, I had experiences with many doctors coming in and expressing their views on gender reassignment. What I had seen there was a sole indignity.”

“Medical ethics is said to be indisputable, but it should be open to discussion. Societal concerns from the past and the rules and norms created by society should be questioned. We were, we will exist, we are not a joke. The truth remains in front of us and this is a matter both of our individual lives and in social life that will last forever. So instead of not facing them or avoiding going through, doctors need to face them too..”

You can access Zeynep Keskin's speech on the UniKuir Podcast: Medical interventions for intersex people

Intersex people in education, employment and organization

In the third session of the forum, Şerife Yurtseven (they/them) made a speech about intersex people in terms of education, employment and organization. They gave examples of various activities where LGBTI + associations and activists in Turkey advocate for intersex in education and employment. Şerife reminded their previous speeches in this regard and the subsequent impacts of these speeches. They especially gave examples of doctors and teachers, who have gained awareness over time, and they suggested that breaking down the prejudices and raising awareness is a demanding process. 

They talked about the school experiences of various intersex people. Şerife highlighted themes that are a common consequence of discriminatory discourses and a lack of intersex awareness. For instance, the experiences of various intersex people were read: these are the people who were called "androgynous", who stated that they felt like "circus animals", who were faced with the words "no, there is no such genetic diversity", who were not taken to university exams because they looks like different from their gender in their identity, and who were not sent to school. Şerife expressed that they was not sent to school because they was intersex, and that their family did not allow their to go to school because they were ashamed of the people and feared that Şerife would be subjected to violence. They then continued their speech as follows: they stated that they continued their education life through their own means, but stated that this situation still has an impact on their business life, too. Suggesting that intersex people need to work harder of all people to achieve the same success and gain opportunities, Şerife pointed out that being constantly asked about gender in all fields, including education and employment, makes us have to explain ourselves. They said that a great responsibility in this regard falls upon families to continue their education, prevent/stop harmful cosmetic interventions and provide psycho-social support.

Later, Şerife stated that since it is so rare in Turkey today, an inclusive and supportive education about intersex should be given to academics in the field of medicine and future generations of health professionals, and moreover said that doctors should be taught that the boundaries of the private life of intersex individuals should not be violated in hospitals. Şerife also pointed out the rights violations they experienced. Şerife underlined the need of strengthening the dialogue among intersex people, especially in the field of health and organization, and solidarity. After Şerife's speech, individual activists, LISTAG Association, Lambdaİstanbul LGBTI+ Solidarity Association and ÜniKuir Association presented their ideas on what they could do for intersex activism in the future. 

Highlights from Şerife Yurtseven's speech are as follows:

“I was never sent to school because my family thought I would cause trouble every day and be the laughing stock of the other children in the village, namely because I was Intersex. After the age of 17, I completed my education externally. At this point, the family has a lot of work to do. The family can explain the teacher about this situation and ask for support; but the family hides, the person hides, and our life passes in secrecy.”

“If you are intersex, you have to work harder than, sacrifice more than, and get more attention than all the people”

“In order to gain public acceptance, first and foremost, our presence in hospitals and educational institutions must be recognized. We should be recognized as much as gays and trans people. But those people were able to organize by paying the price for this recognition; we were able to come together and organize more actively this year. That's why I'm happy.”

“We need support and allies in all areas such as health, organisation, education and family. After all the events we attended among the LGBTI family, the number of which I can't even remember, “Did we do an intersex event? We did it, it's done" and we are put aside.”

You can access Şerife Yurtseven's speech on the UniKuir Podcast: Intersex people in education, employment and organization

What falls to our share?

In the fourth and final session of the forum, Yasemin Bahar (they/them) made recommendations to health professionals, educators and families about intersex people and what responsibilities they have regarding intersex activism, and talked about existing good practices.  

Within the scope of recommendations on health services and health workers, they drew attention to the content and significance of the Informed Parent Consent Form in order to fill the parents' lack of knowledge about intersex children. Yasemin said that risk and the option to postpone should be clearly explained, parents should be provided with complete, accurate and non-discriminatory information, and parents should be given sufficient time to make decisions. As another practical suggestion, Yasemin mentioned the court decision/ethics committee approval and, although it seems positive because it does not leave the decision of surgery only to the parents and individual doctors, they underlined the negative aspects of this practice as it does not leave the decision about their bodies entirely to the subjects. Yasemin stated that the practice of postponing emergency and unnecessary interventions is the most recommended practice by the United Nations and the World Health Organization. Yasemin pointed out that in this way, bodily integrity is not violated, the decision about his/her/their body is left to the individual, traumatic experiences are prevented and the person is not forced into a gender stereotype. In addition to these recommendations, Yasemin criticized the fact that the World Health Organization have defined intersex existence as a disease until a few years ago, and that it is now a pathologized condition in the diagnostic guidelines, even if this has changed. Yasemin drew attention to the fact that the operation called "normalization", which was done to intersex people when they were babies, was actually done with the aim of sterilization/castrating and "adaptation" to society. They criticized the abortion of intersex babies in some European countries and North America as a form of discrimination. Then, they emphasized the importance of providing information from an early age and informing the child continuously as s/he/they gets older, keeping in mind that the subject himself/herself/theirself is a child, and that information should be given directly and only to the child, not to the parent, as they grow. 

Yasemin mentioned the Malta Declaration within the scope of recommendations on legal practices and laws. They pointed out that anti-discrimination legislation should be established and the suffering and injustices inflicted on intersex people in the past should be compensated, and gave examples of compensation cases in some countries. Yasemin then gave examples from countries where the Informed Consent Form is mandatory or cosmetic interventions are prohibited. They talked about countries where there is legal protection from discrimination and practices that can change gender classification in official cards. 

In the part of their presentation about families, Yasemin suggested that families should accept that their children's perception of gender identity and performance may differ from what their families think, avoid intervention when interventions are not mandatory medically, provide information to the child from the age of 4, and not hide their medical history from their children. They underlined the importance of providing non-pathologizing, affirmative and autonomous psycho-social and peer support for families. 

In the part of their presentation about educators, Yasemin stated that they should educate themselves on this subject with internal training and new resources, in the same way, in the relevant courses, they should give non-discriminatory information about the presence of intersex, ask students' names and titles (way of addressing), not ask about their health history and gender when not necessary, ask if they have a need for regulation at school/class, and express to their students that there is zero tolerance for interphobia and discriminatory behaviour.  

As for LGBTI + associations, Yasemin suggested that they organize internal training in the field of intersex awareness for intersex activism, organize intersex awareness and visibility-increasing activities, produce and disseminate resources, and include intersex people in their policy documents. 

Finally, Yasemin concluded their speech by reminding that the things that everyone should do, both for intersex people and for all LGBTI+s, are: to listen to the subjects, to support visibility efforts, to take a stand against the binary gender system and sexism, and not to use the intersex people as a pawn just to disproof the binary gender system.

Highlights from Yasemin Bahar's speech are as follows: 

“Intersex people should not be denied from exercising their right to access their medical records. I learned that I was intersex by chance at the end of secondary school. If I hadn't learned, maybe I wouldn't have known for years. This is a very common situation. Therefore, partly because of this, we do not know the frequency of intersex people.”

“I have one girl and one boy birth certificate issued for me. The hospital issued two documents and said, "Get the surgery you want, then return what you don't use”

You can access Yasemin Bahar's speech on the UniKuir Podcast: What falls to our share?

Comments from the participants after the forum: 

The audience participating in the Forum, thanks to both the speakers' experiences and the videos they watched at the beginning of the session, stated that they noticed lots of wrong information they knew or they did not know at alland they expressed that they heard about branding and difficulties that they had never thought about before. One of the two most discussed topics in the question and answer sections at the end of the session was what can be done together against the violations of rights in health services between the participants, who are medical specialists and students, and the speakers; the other was how to increase the visibility of intersex people and the work falls upon everyone in terms of solidarity with intersex people with the participation of independent LGBTI+ activists, LGBTI+ associations and volunteers. 

“I had never heard of the Malta Declaration. Even though it's not so new and every request risks not being inclusive for everyone, if I think about what intersex people are demanding, I can go look at this declaration now.”

“No matter how much effort is made to "globalize" the demands of intersex people, they have different experiences locally. So the response to being intersex was as diverse as the variety of intersex 'states'. For instance, granting the right to abortion just because there is an intersex fetus was a WTF thing for me.”

“There was the criticism that other queers leave us a little alone, and the ways opened because of the LGBTI+ struggle, and issues such as self-acceptance were discussed. Of course, we also witnessed the self-criticism of intersex people throughout the forum. They tried to discuss in detail the question "Why can't we organize?" It was very valuable to see this self-criticism, solidarity and struggle together.”