In a progressive move, the Tamil Nadu government has banned sex reassignment surgeries on intersex infants and children. In a Government Order (GO) released earlier this month, the state government quoted a World Health Organisation report, that clearly says that such “sex normalising procedures” are medically unnecessary and often irreversible, with lifelong consequences for the physical and mental health of the intersex person.
‘Intersex’ is a term used for persons who are born with variations in sex charecteristics, that do not conform to what we typically think of as ‘male’ or ‘female’. For instance, they may have genitals that are not typically male or female; or their chromosomes may not be ‘xx’ or ‘xy’; or they may have hormonal variations that are not typically understood as ‘male’ or ‘female’. In several cases, doctors and parents perform surgeries on intersex infants and children to make them ‘conform’ to male or female gender – however, these surgeries are medically unnecessary, and can be harmful to the children. Experts have maintained that intersex children should be allowed to grow up and decide what they would like to do with their bodies.
Now, with this GO, Tamil Nadu has become the first state in India to ban such surgeries. The GO follows two important judgments: In 2014, the Supreme Court in the landmark NALSA judgment had said that such surgeries on infants and children should be banned; and earlier this year, the Madurai bench of the Madras High Court had reiterated the Supreme Court’s stand, and suo motu asked the Secretary of Health and Family Department to ensure that this is done in the state.
The government has said that unless there is a life-threatening situation, such surgeries should be banned on intersex infants and children. Further, they’ve ordered the formation of a committee comprising of a pediatric surgeon or urologist; an endocrinologist; a social worker or psychology worker or intersex activist; and a government representative not below the rank of Under Secretary. This committee, along with the Director of Medical Education in the state, will advise the government on whether a specific case is a life threatening situation where a sex reassignment surgery needs to be performed on a minor, and the government will take the final call.
The GO has been welcomed by activists from the LGBTQI+ community. “It’s a positive step, but there are certain gaps that need to be addressed,” said intersex activist Gopi Shankar, who had written to the Health Ministry regarding the issue.
“The first is that they haven't mentioned what surgeries are included under the ban and haven't specified the types of intersex variations included. Also, we need a more scientific approach to determine whether something is life threatening,” Gopi said.
Srishti Madurai, an organisation that Gopi works with, released a statement which further recommended that the government must specify punishments for those who don’t follow the ban.
Gopi further said, “Currently, this is a decision that has come from the judiciary and has become a GO. It needs to become a law however for it to be implemented properly. The court's powers are limited."
C Moulee, founder of Queer Chennai Chronicles meanwhile pointed out that hospitals need to be sensitised on the subject as well for this GO to be implemented well. "This is definitely a precedence to tackling the larger issue," said Moulee, "But the awareness must start from hospitals. They are the ones who suggest these surgeries and counselling must also be given to parents of intersex children who are under pressure due to social conditioning."