Intersex Day

Aleksander Berezkin. Photo: Katya Repina.

The first evidence of intersex people in Russia is found in the 18th century, with greater church interest than state interest. In the 19th century, the state began to get involved, including in a case of the “double sex” of a peasant baby in the documents of the Office of the Third Department of His Imperial Majesty in 1837. Local doctors and the authorities were ordered to monitor the health of the child, and ensure the “holistic conservation” of the child’s body in the event of death. From the second half of the 19th century, cases of intersex are increasingly recorded in scientific and medical periodicals, but royal power inhibited medical control over intersex bodies, compared with Western society at that time.^[1]

After the 1917 revolution, medical experts secured relative independence from the government and the situation of intersex people began to change. The new government sought to ensure the “development of the productivity of the working class” in accordance with the Marxist ideology. In 1926 the Soviet People’s Commissariat of Internal Affairs issued a decree prescribing regulations for citizens “with the characteristics of hermaphroditism” who sought to change their name and gender. Local medical institutions had to confirm a dominant gender. Several dozen cases were examined in the first decade. Of 36 people, 27 made appeals themselves, with 4 identified by authorities during military medical examinations.^[2] The historian Irina Roldugina suggests that these data show a desire by the identified intersex individuals to take advantage of medical capabilities: most had surgical operations, some received hormone therapy, and some received psychiatric help.^[3]

By the mid-1930s, public conceptions of family and sexuality began to change.^[4] The state, represented by the Communist Party, began to pay close attention to the development and education of a new type of Soviet man, demarcating the limits of his intimacy and restricting bodies and behaviour to meet patriarchal heteronormative norms. As an expression of human individuality and variability, intersex no longer fit into the new Soviet collective order. Intersex people were marginalised and stigmatised, and even became a taboo subject for discussion in specialist medical journals.

Between 1958 and 1991, intersex cases again became interesting to Soviet clinicians. The Institute of Experimental Endocrinology and Hormone Chemistry of the Academy of Medical Sciences of the USSR began to conduct long-term observations of intersex people, including surgical interventions, and the development of protocols for hormone therapy and psychosexual adjustment.^[5] These were accompanied by changes to the legislation on “correction of surname, name and patronymic name in connection with a change of gender (for hermaphrodites)”.^[6] Scientific and medical debate began to question the appropriateness of surgery. “Conservatives” believed that “any kind of surgery for hermaphrodites was considered unnecessary” while “innovators” believed that successful “surgery, and creating or deleting certain organs” gave moral, domestic and social satisfaction to the patient and the surgeon; the individual results of operations confirmed their full necessity.^[7] This “innovative” view became dominant in Soviet and then post-Soviet medicine.

After 1991, each of the former republics of the USSR began to implement their own legislative and medical programs on the treatment of intersex people. Intersex people in Russia are usually described as people with “disorders of sex development”.^[8] Current clinical debates focus on issues related to defining “sex”, and “the importance of early child education” about sex, sexuality and gender, “because people cannot live in society without gender. It is almost impossible”.^[9]

There are now legislated federal standards of care for intersex people in Russia. These describe clinical procedures that are free for children aged under 18, and also regulations assigning different grades of disability. In 2001, a federal law on bioethics was drafted, proposing a requirement for written consent by parents or guardians in cases of “gender correction” in “children up to 16 years”^[10] but the draft law was rejected by the State Duma (parliament).^[11]

Aleksander Berezkin. Photo: supplied.

Doctors have particular importance in such a system. They are not only authorities, but also representatives of the state in matters under their jurisdiction. They are driven by a desire to help people with their physiological problems, and also driven by the need to report to the authorities on the state of human resources, through bureaucratic procedures, health statistics and other requirements. They must classify, identify deviations from the “permissible norms” and record them. This creates a problem of dual responsibility: responsibility to the individuals affected, as a professional, and responsibility to the state. This limits their independence.

There is a functional emphasis on population health. Initially, the representatives of the Soviet Marxism prioritized “productivity” and populations as functional and usable resources. This trend has since continued, only with a changed ideological framework, finding an ally in the Russian Orthodox Church. Now in Russia there is discussion about the “traditional values of the family”. Intersex people often cannot perform the function of “reproduction” and so we are not necessary for such a system, so we are seen as “rejected material”. We fit into a “disability” (or dysfunction) model; only existing within certain parameters, where we try to be normal and integrate into society.

Soviet medicine continues to influence medical practices, with cheap and accessible medicine, delivered in ways that are ideologically compatible with authoritarian forms of government. Western medicine is considered only when it does not lead to profound changes in the system or any loss of control, unless it can generate money. The variability of intersex bodies has no role in such systems.

There are many additional challenges for intersex people in Russia. The first challenge is linguistic. The word “intersex” has an ambiguous Russian translation. The word “sex” is not translated as biological sex, biodiversity or corporeality, but instead usually carries a meaning related to sexual behaviour and sexual orientation. The result is that the socio-political and legal understanding of the term “intersex” is lost.

The second challenge is the taboo of topics relating to “sex and sexual education”. All phenomena perceived to be outside the conventional gender binary system are considered medical, and rarely discussed at scientific conferences and seminars.

The third challenge is the medical community and its relationship with intersex people. Medical experts continue to use the “innovative” Soviet approach, namely surgeries on intersex children, and management to control psychosexual adaptation. There are hundreds of operations on intersex children and adolescents without any monitoring by civil society organizations or ethics committees. Those ethics committees include representation by the Russian Orthodox Church.

Intersex children are categorised under “sexual perversion”, requiring special psychosexual adaptation to manage sexual orientation and gender identity. The aim is to “normalize” the behaviour of intersex children, in accordance with their assigned gender.^[12]

Another feature of this medicalization is that intersex children and sometimes adolescents are completely excluded from exchanges of information between doctors and their parents or guardians.

In addition, the selective abortion of intersex embryos takes place. Neonatal screening is routine in Russia, including for congenital adrenal hyperplasia, but the test results are not disclosed; statistical data is not publicly available. Doctors report limited information directly only to affected adults.

The fourth challenge for intersex people in Russian society is the high level of xenophobia and homophobia, and in particular a correlation between intersex people and the LGBT community. On the one hand, the intersex community is afraid to join LGBT, as this will inevitably create additional discrimination against us in a very homophobic society. On the other hand, the LGBT community itself has intersex-phobia. It is not accepting of intersex persons due to internalized homophobia. The result is that intersex people who are also same sex attracted and/or transgender are forced to live in a “double closet”. The situation for people with HIV is similar, and triple discrimination can occur if an intersex person has HIV. This inevitably leads to depression and other negative psychological states. Moreover, many LGBT organizations use letter I in acronyms, but only superficially, without actually helping intersex people; often these organizations only represent the LGB group. In recent times this has begun to change in a positive way, thanks to the development of intersex movements in the region and internationally.

The fifth challenge is the complexity of changing from assigned gender, if this is needed. It is necessary to obtain a diagnosis of “transsexualism” in some cases.

The sixth important challenge is the quality and cost of medical services, and their availability for intersex people. For example, some intersex people consciously seek disability to obtain discounts on treatment. This comes at the cost of discrimination against people with disabilities in the workplace, but there are often greater worries about access to medication.

Thus, from the moment of birth and throughout subsequent stages of life, intersex people are faced with a number of different social, legal, psychological and medical problems. We have to survive in a society where are very few opportunities for the full development of healthy intersex persons. This happens despite isolation because national borders are porous, and information seeps through. Intersex persons face normalizing operations, constant medical examinations, and sometimes special monitoring and “necessary” medical or psychosexual experiments to manage sexual orientation and identities. Outside healthcare, we live with the reality of a repressive patriarchal heteronormative society, and in some cases homonormativity. This includes taboos about discussion of physical variations, especially when these relate to sexual variability, and the silencing of descriptions and language relating to intersex bodies, even in so-called liberal academic circles. This leads to bullying, discrimination, violence and more.

There are no specialists who can work with intersex people outside a traditional medical approach, including in NGOs and social service organizations. In the worst cases, intersex people are subjected to discrimination and isolation, and any prior history inside mental institutions implies an end to a person’s social life in Russia.

In this extremely difficult situation any person who discloses their intersex status, let alone begins to engage in activism, faces a complex and dangerous situation. Despite this, the movement for the rights of intersex people began to develop in Russia in 2012.

The first intersex initiative in the region originated in Ukraine in 2011, perhaps due to the geographical and geopolitical location of the country; its proximity to Europe and openness to new ideas. The first intersex activist in the region was Julia Pustovit; her story deserves a separate article. Briefly, she has been seeking to change the gender on her passport since the 2000s, but the Ukrainian medical system can only “help” change documents for transgender people with a diagnosis of “transsexualism”, not those with an intersex variation. Intersex people need to hide their biological status, or they can become transgender and lose access to medical help for issues associated with their intersex status. Julia began to look for other intersex people who would be interested in creating social change.

In 2012, Julia and I met. I was the first Russian intersex activist on the Russian-speaking internet. By this time, I had known about my intersex variation, 47,XXY or Klinefelter syndrome, for more than 10 years, but I only learned the term “intersex” in that year. At first I was looking for information on intersex activism and contact with foreign intersex activists; my first contact was with the American intersex activist Hida Viloria. I was influenced by these contacts, and I started working as an intersex and LGBTI activist, organising educational events on intersex issues for the LGBT community in Vladivostok. With support from Julia, I created a closed information group on Facebook called “Association of the Russian-Speaking Intersex” (ARSI) for intersex people and allies, in August 2013. Gradually, information about intersex people and intersex activism is beginning to spread in the Russian segment of the internet, especially among LGBT activists, but in 2014 I was forced to leave Russia in the US as a result of a homophobic campaign against me. The activities of the group were suspended for some time.

Even so, we have connected a new intersex movement in Russia to the international movement. This became possible because, when I started living in the United States, I gained the “privilege” of being openly an intersex person in the Russian-speaking space without the fear of physical bullying. I also gained direct access to English-language sources of non-pathological information for intersex people, and I became able to distribute this in Russian-speaking spaces. Thirdly, I am involved in an international network of intersex activists, human rights organizations and researchers on intersex issues. The fourth important factor was the ability to apply for grant support from the Astraea Lesbian Foundation for Justice and other funds for intersex activism in Russia. All this affects my own language for understanding and describing my own intersex identity, and this influences my work with the intersex movement in Russia.

The first Russian language publication about intersex activism was published in 2014.^[13] In December that year, LGBTQ activists held the first public actions in Moscow in defence of intersex children with the poster “Intersex. They make enforcement operations on genitals in infancy. Enough!”, but society doesn’t know who intersex people are, so we didn’t get any public response to this action.

In 2015, me and a transgender Russian activist, Yana Sitnikova, began to cooperate in translating English-language information to support intersex people in the Russian internet space. Several educational activities relating to intersex activism were held in different Russian cities. I did an interview with Radio Liberty in October 2015 for a Russian-speaking audience.^[14] This interview led to multiple contacts from intersex people in different post-Soviet Union republics. New participants came to join ARSI, including intersex people from Ukraine and Kazakhstan. Of course, there were also negative consequences. There were many comments that the intersex movement is an alien Western movement. It turned out that not everyone can learn about the details of intersex lives, even some academic scholars were not ready for such revelations. But in general, the interview had more positive than negative effects. In particular, from this point on, we can talk about a third period of intersex movements in Russia – the youth.

New young intersex activists and queer activists are beginning to form a new understanding not only of Russian intersex identity, but also to define new directions to develop the intersex movement in Russia and its involvement in the international intersex community. Young intersex activists from ARSI have begun to take part in international conferences, conduct research on the situation of intersex people in the post-Soviet countries, try to understand the intricacies of national and international legislation on intersex issues, and speak out in Russian public spaces.

But we still have a lot to do. We still have a problem of funding and support for our projects, and we are still so very little for all of the huge country that is Russia. But there are small successful steps. Our group is now working not only with LGBT activists, but also with professionals (social workers, academic researchers, psychologists, friendly doctors and lawyers), who are interested and willing to support the intersex community. We have access to psychological and legal counselling for intersex people. A group of translators is gradually forming. We have begun to start the systematic translation of books and sources on intersex, including the book by Georgiann Davis, Contesting Intersex. In addition, there are some research areas within ARSI: the psychological study of intersex-phobia; analysis of the International Classification of Diseases and its impact on the medical system in Russia; research on the genders and sexual orientations of intersex people. I am personally interested in studying the medicalization of people with chromosome variations, and the relationship between this and cognitive or psychological characteristics. ARSI participants are slowly starting to be invited as independent experts, providing alternative perspectives on intersex issues. The recognition of intersex issues has begun.

We live in a country where relationships between people are still based on a hierarchical chain of command, and peer communications and recognition of the uniqueness of individual and social groups are simply excluded in such organizations. Thus, Russian children learn to think in stereotypes, imposed from above, to submit to the pressure of the majority. The Orthodox Church has penetrated into private and intimate lives. Any departure from the heteronormative binary system is sharply condemned. This joint activity of the state and the church leads to reduced levels of tolerance in society, and increased aggression. Discrimination and bullying against intersex people persist and we have to assume that the situation in Russia will deteriorate in the near future, in part due to the creation of pro-government youth and children’s organizations.

We believe we can break the ice of silence around intersex issues in Russia. And the expansion of communications with the international intersex community will create possibilities for the emergence of an alternative non-pathologising vision of intersex human beings in Russian society.

– by Aleksander Berezkin, independent researcher and founder of Association of Russian-Speaking Intersex.

[1] Ira Roldugin. Intersex: from pathology to new opportunities// Queerfest 2013. 20 years after the abolition an article 121 of the criminal code of the RSFSR. Saint-Petersburg. 2013.
[2] Healey. Dan. Bolshevik sexual forensics: diagnosing disorder in the clinic and courtroom, 1917-1939. Northern Illinois University Press, 2009.
[3] Ira Roldugin. Intersex: from pathology to new opportunities// Queerfest 2013. 20 years after the abolition an article 121 of the criminal code of the RSFSR. Saint-Petersburg. 2013.
[4] Healey. Dan. Bolshevik sexual forensics: diagnosing disorder in the clinic and courtroom, 1917-1939. Northern Illinois University Press, 2009.
[5] Golubeva I. V. Hermaphroditism: Clinical Features. Diagnosis. Treatment. Moscow, 1980.
[6] Changes rules, additions and corrections of the records of civil status acts 1977. Article.2., point T. Available from: http://www.businesspravo.ru/Docum/DocumShow_DocumID_33511.html – 20 October 2016
[7] Serdyukov, G. M. Forensic gynaecology and obstetrics. M. 1964
[8] Kalinchenko N. Yu, Tulpakov A. N. New classification of diseases connected with disorders of sex development. Discussion of the international consensus on the revision of terminology and classification of hermaphroditism. Available from: http://cyberleninka.ru/article/n/novaya-klassifikatsiya-zabolevaniy-svyazannyh-s-narusheniem-formirovaniya-pola-obsuzhdenie-mezhdunarodnogo-konsensusa-po-peresmotru – 20 October 2016
[9] Journal of “Andrology and genital surgery”. Volume 16, No. 3 (2015)
[10] The draft Federal law “On Legal Foundations of Bioethics And Guarantees of Its Security”, 2001. Available from: http://www.hrights.ru/text/b10/Chapter3.htm – 20 October 2016
[11] The RESOLUTION of 15 March 2001 No. 1253-III GD. Available from: http://www.medinfo.ru/medzakon/zdrav_rf/organ_act/azo75.phtml – 20 October 2016
[12] Scientific library of dissertations and abstracts. Available from: http://www.dissercat.com/content/khirurgicheskaya-taktika-pri-gipospadii-u-detei-s-narusheniem-formirovaniya-pola
[13] Alexander Berezkin. The intersex – between sexes. Available from: http://bok-o-bok.ru/opinion.asp?pid=28&lan=2&tid=1192 – 20 October 2016
[14] The third sex. Available from: http://www.svoboda.org/a/27311800.html – 20 October 2016