Intersex Day

Around my thirtieth birthday I ventured in search of answers about my body. Or, rather, it was only then that I did it with determination; it’s impossible to pinpoint the exact moment of my life in which the doubts about my body, my identity and my past stacked up until I couldn’t ignore them anymore. Maybe it was when I was a teenager and I started taking conjugated estrogens, not knowing what they were, without questioning their purpose; perhaps it was in anatomy class, when the professor told us about Klinefelter and Turner syndromes, and something sounded familiar to me. Maybe it was when I was eighteen and I hadn’t menstruated yet; or when I started to desire intimacy but discovered an instinctive terror in my skin; it was not the lack of libido, that stopped me. A kind of reflective pain, a shivering twinge like those I felt in my infant body, when the scars of surgeries were still fresh in the flesh.

Before that final moment, I had asked a few questions. Not that I hadn’t gotten answers at all. But they were perfunctory, and they were founded upon a rationalization that took me years to deconstruct: that I was born with a problem, and it had been corrected. Maybe that’s why I hadn’t inquired in any depth, until the need to know was greater than the fear in knowing. I think, in a way, I always knew what I was going to find. Even then, the word intersex meant nothing to me. Instead, every time I searched for the terms “vaginoplasty” and “ovotestis”, a word came up that made me shiver: hermaphroditism. Today this feels different. Sometimes I feel how that term, although medically inaccurate, reverberates within me in all its mythological dimension, giving me strength. Not the myth collected by Ovid, but the myth of the androgyne, described by Plato. But at the time, the “h” word evoked in my mind images not as glamorous as the Borghese sculpture. I had feelings of confusion for the fantasies and desires I carried inside of me, of a sexual orientation that produced suffering not because I had it, but because I kept myself from fully living it, out of fear. Maybe this explained everything?

I appealed to the memories of members of my family, because the medical institution denied me access to my clinical file, claiming that the documents corresponding to the procedures performed in my childhood had been “disposed of” many years ago. My parents, seeing the agony consuming me, understood how crucial this information was to me. Although they took their time to open up about what they knew, it was thanks to them that I finally had all the necessary elements to understand the circumstances of my birth and the decisions that had been made. Of course, for me, it was not an immediate process either. Assimilating the facts, as well as their impact throughout my life, has been perhaps the most complex process that I have faced. Fortunately, I found support in my family, but also in a group of wonderful people I met; it was in 2014 that I discovered the Brújula Intersexual project, but it was a year later when I contacted Laura Inter, and from then on we exchanged messages, intermittent at first, due to the distrust I still felt about opening myself up to others, even to people who weren’t going to judge me. Through the intersex adults support group, I learned the stories of other intersex people in Mexico and Latin America, where I found echoes of my own story. During that time, I began to assimilate that, in truth, there was nothing wrong with my body when I was born; that there were many people like me, who had been subjected to unnecessary surgeries, just so that our sex characteristics conformed to a notion based on prejudices about human sexuality. It was a long and tortuous period, but necessary, because I could no longer live with a lie about something so relevant to me. In the end, the truth had to come out.

#

Mexican society, unlike the great majority of the countries of the West, is a heterogeneous society. I am not referring here to the ethnic composition, but to the cultural diversity that daily coexists, which comes from the customs inherited from the specific syncretism of each region with the Western culture imposed during the Colonial period. There is not just one Mexico, but many, and that is tangible for anyone who has a deep contact with the country. It’s a land with a vocation for diversity, even in relation to the subjects of sex and sexuality, despite the profound cultural and political influence of Christian doctrine and its institutions.

On the other hand, Mexico is also a country with marked social inequality, due in great part to ineffective economic policies undertaken by administrations since the 1970s. This inequality limits the access of a large majority of the population to opportunities and services. The federal and state governments still function as providers of a welfare state, constantly challenged by policies that dismantle and reduce the resources available to public institutions serving the bulk of the population. This includes health services. Eva Alcántara explains the subject with clarity:

In Mexico, a country full of contrasts, the health care system is a combination of public social security, public care services and private medical practice. In theory, a person can choose between some of these options, but in reality, a large part of the population goes to state institutions because they have no alternative, and yet almost always pay pre-established quotas according to various indicators that classify their economic possibilities. The country’s poverty rates provide more than enough reason to have saturated public health institutions. (free translation from “Rompiendo fronteras: activismo intersex y redes transnacionales,” in Los contornos del mundo, 2009, p. 133)

In the investigations of Eva Alcántara, as well as the testimonies of intersex people subject to interventions by medical institutions, it seems evident that third-level hospitals with intersex clinics^[1] are few in number, and in great demand. In the case of private hospitals, even with technology and specialists, a protocol of care is rarely followed, such as those that public institutions have implemented since the late 1960s.

#

I was born in Mexico City in 1981. When my mother found out she was pregnant, and because she had a high-risk pregnancy, she went to the Mexican Social Security Institute (IMSS), to which my family was affiliated. Having a history of high-risk pregnancies, she attended the perinatology wing of ​​the National Medical Center (now Siglo XXI Medical Center), where she gave birth to me. I was not “diagnosed” at birth – neonatal screening wasn’t the protocol at the time – but months later, my mother returned with me because she noticed something atypical in my anatomy. Only then I was sent to La Raza Medical Center, home of an IMSS intersex clinic. From the age of six months to fourteen years, I went in and out of the facility several times each year for consultations, sampling and analysis, for odious inspections of my genitals, and three surgeries, without any justifying medical emergency; just for being born with variations of sex characteristics.

Although there are many people in Mexico and Latin America who, like me, were subjected to such medical protocol because of their intersex variation, this is not is the more typical experience in the region. In Mexico, not all intersex people are diagnosed and subjected to interventions by medical institutions. The common denominator of our experience is, in fact, to have grown up feeling alien in a society that values ​​the existence of an unquestionable binary gender order, which still expects naively that the biological markers of sex are well determined and define an expected social and sexual behaviour. A supposedly immutable and inflexible biological order, as if nature worked that way. Most often than not this feeling can’t be articulated in words, much less in a narrative: it may be that a person lacks of awareness of their history or past; it may be that the sociocultural determinants of the local environment limit the ability to speak of it; and considering the high level of social inequality and the fact that many people do not even complete basic education, it is also possible that they may not find the way or the means to express that experience in words. As Mauro Cabral has said, not all intersex people assume themselves as such; many live their lives as individuals with a well-assimilated gender identity within society, even when it is continually challenged by the reality of a body different from the stereotype; a corporality that the social imagination excludes from the possibility of a full and happy life, marked with the accusation of sin, of divine punishment, of abomination. These people can live a relatively quiet life, almost always under the condition of “keeping the secret”, and which does not save them from enduring physical and psychological abuse.

Judgement sometimes begins in the family environment, before any surgery: fathers and mothers are the first to face the judgment of their relatives, friends and acquaintances, at least in their head; the fantasies that parents have about “what others will say” greatly condition their impulses and decisions in the first few days after the birth of the intersex baby. This is magnified in large sectors of Mexican society, terribly sexist, where being born with genital “ambiguity” is a tragedy with long-term repercussions in the upbringing of the infant, because it is not known “how will the child be raised”. What social role will prevail, based on stereotypes of gender, over the individual’s potential to aspire to full development and happiness. Under this atmosphere, homophobic and transphobic concerns and feelings arise, not knowing how to confront the possibility of a sexual orientation other than heterosexual, and a gender identity that may or may not conform to society’s binary expectations. Questions that arise from the fantasy that the sex and sex characteristics of a newborn infant will definitively shape and determine these traits of the human being.

We can’t overlook the discrimination suffered by intersex people in other areas. In 2012, a child with an intersex condition, from the state of Puebla, was stripped of his right to education by the authorities of the school he attended, who considered that it was not an adequate institution for the “problem” that the child presented. The “problem” was that his mother had requested a special permit so that his older brother, a pupil of the same school, could escort him to the bathroom to prevent aggressions from his classmates, since the child needed to sit in order to urinate. In the work environment, teasing, aggression and other types of abuse are present, not because a person is openly advertised as intersex, but because of the way the person is “read” by colleagues as unable to fulfil a stereotyped expectation of a gender role or gender expression, or simply by the androgyny of an intersex person. The above is exemplified in the testimony of Mar IS, from Intersex y Andrógino:^[2]

You can perceive me in a wrong way very easily, it all depends on the prejudices of people. But the problem is not how they perceive me, the real problem is how these people act out their perceptions and prejudices […] In the course of my life I have experienced psychological violence and sometimes also physical violence, all as a result of the misperception of my gender identity or sexual preferences, and the social prejudices that exist against any person perceived as non-heterosexual or non-cisgender.

Until 2016, only the criminal code of Mexico City and 11 of the 32 states of the country defined hate crimes against the LGBTTTI (lesbian, gay, bisexual, transsexual, transgender, transvestite and intersex) population as aggravating circumstances in cases of homicide. On the other hand, CONAPRED and other state agencies deal with complaints of discrimination against all vulnerable groups in the population. This includes, in theory, the intersex population, however, people in these circumstances usually don’t know how to address their complaints. This is a sign of an urgent need to seriously address intersex issues and to get political and social actors to understand the specific matters that people with variations of sex characteristics face regardless of whether or not they assume themselves to be intersex.

#

After several months of interacting with Laura Inter, one day I felt the impulse to help with translations and transcriptions from English to Spanish for the Brújula Intersexual website. At some point, motivated by the reading of those texts that I translated, and others that I found on the site, I decided to write my own testimony. It was a critical moment, because it meant revisiting my past, with months of reflection on what had been one of the hardest moments of my life. The response of the people in the support group was positive, reinforcing a sense of community that inspired me to start my own project, Vivir y Ser Intersex. And, without realizing it, I entered fully into intersex advocacy. It made sense: if not us, who else was going to do it? At the invitation of Laura, at the end of that year I participated in what was my first public event: a training event for CONAPRED staff and executives. I still remember that I was nervous when giving my testimony for the first time before a group of strangers. Today I treasure that moment. I would gladly do it a thousand times, even with trembling voice and shaking hands. It was one of the most liberating and instructive experiences of my life. I discovered that it is natural to feel fear when it comes to something so relevant; my body, in this case; nothing less.

Currently, the main focus of intersex activism in Mexico is to increase the visibility of intersex. However, it is not limited to that: the movement also works directly with intersex adults, providing a safe space to talk about what is not possible to speak about openly with others; and with parents, giving them advice to empower them and help them to engage in a dialogue with doctors.

Intersex activism in Mexico has also been able to impact other situations. Following the 2016 presidential initiative in favour of same-sex marriage, in February 2017 the federal Ministry of Health convened various social actors to draw up a medical health care protocol, free of discrimination, for people of sexual diversity. Together with Brújula Intersexual and Eva Alcántara – an immense ally of the movement – I had the opportunity to participate in the elaboration of recommendations to improve the first draft that, in the case of intersex care, still reflected a pathological medical practice based upon sex and gender stereotypes. The recommendations submitted were happily reflected in the final version published in June 2017.^[3] The document raises doubts and concerns about the relevance of surgeries at an early age, and takes up statements such as the Yogyakarta Principles, the UN joint inter-agency document of 2014, and the 2017 public hearings of intersex people before IACHR. In a more pragmatic way, a call is made to respect the physical integrity, bodily autonomy and self-determination of intersex people, regardless of their age, which is derived from a recommendation to postpone surgeries and irreversible treatments until intersex people can participate in decision-making by themselves. Likewise, it states the need to guarantee the newborn’s right to legal identity, without making this conditional on the practice of sex assignment surgeries.

#

Looking in perspective, I think about the consequences of the decisions that were made about my body. I wonder how different my life would be if I had been able to choose. It is a difficult question, because circumstances did not facilitate it. But knowing this changes everything. Every day I think about this, and about many other things: about what I can do so that my story is not repeated on other people. A thought comforts me: I am not alone. We are many. And here we are.

– Hana Aoi, Vivir y Ser Intersex (Living and Being Intersex)

[1] In Llamado Intersexual (2012), Eva Alcántara, citing Esmer, Castillo and Calzada (2000), describes an intersex clinic as a workgroup made up mostly by medical specialists who meet at a specific place and time, in charge of “discussing issues and making decisions concerning intersex patients.” (free translation)
[2] “¿Cómo es que la homofobia y transfobia afecta a las personas intersex y andróginas”, by Mar IS. Intersex y Andrógino <https://intersexyandrogino.wordpress.com/2017/09/29/como-es-que-la-homofobia-y-transfobia-afecta-a-las-personas-intersex-y-androginas/> (consulted in October 6, 2017)
[3] This protocol, published in Spanish, can be found at the following link: https://www.gob.mx/cms/uploads/attachment/file/233408/210617Protocolo_Comunidad_LGBTTI_DT_Versi_n_III_17_3.pdf. I suggest reading the definition given to the term “sex” (pp. 21-22), and Guía de Recomendaciones para la Atención Médica de Intersexualidad y Variación en la Diferenciación Sexual (Recommendations Guide for Health Care of intersex and variations in sex differentiation, pp. 36-42).