Senator Scott Wiener (D-San Francisco) introduced SB 225: the Bodily Autonomy, Dignity and Choice Act, to provide children and their families a chance to make informed decisions about major surgeries to change variations in the appearance of genitalia and other sex characteristics. Under SB 225, these surgeries will be prohibited when a child is under the age of six (except in the cases where it is medically necessary), allowing for parents to continue to learn with their child and child’s physician regarding the potential need for medical interventions. SB 225 is cosponsored by Equality California, interACT: Advocates for Intersex Youth, the National Center for Lesbian Rights, and the ACLU of California.

One to two percent of people are born with variations in their genitalia and sex anatomy, some of whom identify as intersex. Parents of children with these variations are often offered medically unnecessary surgical interventions – such as major surgeries to cut a clitoris, create a vagina for penetrative sex, remove hormone-making organs, or move a working urinary opening – which are typically performed on children under two years old and often without a complete discussion of the various risks. These surgeries may result in extreme scarring, chronic pain, chronic incontinence, loss of sexual sensation, post-traumatic stress disorder, incorrect gender assignment, and the need for additional surgeries to treat complications from the original surgery. SB 225 will allow parents to make a decision, in consultation with their child and medical professionals, once a person is old enough to participate in decision making about whether or not a surgery to change sex anatomy is right for them. 

For every person, identity and sense of self — including gender — can evolve over a lifetime. But many of the procedures performed on infants with variations in their physical sex characteristics are permanent and irreversible. SB 225 will provide a way for families and children to have autonomy over decisions about their children’s bodies and their identities by delaying these surgeries until a child has reached six years old. Six is around the time when research shows that for many, gender identity has begun to form and take shape. The only way to know what an individual will want is to safely delay these non-emergency surgeries.

SB 225 will delay procedures to reduce the clitoris, create vaginas, and remove hormone-producing tissues often performed on infants – such as clitoroplasty, clitoral reduction, clitoral recession, gonadectomy, procedures to lengthen or reroute a urethra from its native orifice, vaginoplasty, urogenital sinus mobilization, and vaginal exteriorization. 

Many adults who underwent these surgeries as infants have expressed deep concern and anguish about the procedures. The intersex community is leading the movement to ensure that no matter what gender identity a person grows up to have, everyone born with unique sex anatomy should be able to play a role in major healthcare choices. Organizations such as the United Nations, Human Rights Watch and the World Health Organization agree that these surgeries can be harmful and should only be an option when the individual is able to participate in an informed decision. Many in the medical community agree: in 2020, two U.S. hospitals committed to stopping infant clitoral and vaginal surgeries, citing issues raised by intersex and human rights organizations.

“People should have the chance to make informed decisions about their own bodies instead of having those decisions made for them and without their input,” said Senator Scott Wiener.“This legislation gives children and their families more time to research and opt in or out of non-emergency surgeries to irreversibly change a child’s sex characteristics. We must provide people the ability to make important healthcare decisions for themselves – especially when healthcare decisions are associated with a person’s gender assignment, and can result in long-term pain, PTSD, depression, and a loss of sexual sensation. The intersex community is leading this movement, and I am proud to work with a broad coalition of LGBTQ, civil rights, and health advocates to get this legislation passed.”

“The LGBTQ+ community — and transgender, nonbinary and intersex folks in particular — have been fighting for decades to secure our rights to make decisions about our own bodies. That fight continues today,” said Equality California Executive Director Rick Chavez Zbur. “Children born with diverse physical sex traits and their parents should be able to participate in the critically important decision-making process regarding medically unnecessary and often irreversible surgical interventions. We are proud to stand with Senator Wiener and the intersex community in this important work to safeguard the human rights of all Californians.”

“Building on 15 years of advocacy work by interACT, we saw two premier children’s hospitals finally commit to stopping infant clitoral and vaginal surgeries in 2020. Now it’s California’s time to shine,” said Kimberly Zieselman, Executive Director of interACT: Advocates for Intersex Youth, herself an intersex woman. “SB 225 builds on SCR 110, California’s 2018 resolution that established the state’s commitments to equality and autonomy for people born with variations in their sex anatomy.”

Becca Cramer-Mowder, Legislative Coordinator and Advocate for the ACLU of California, said: “SB 225 gives California the opportunity to advance equality by protecting the physical and psychological well-being of children born with variations in their physical sex characteristics.”

“Current medical practice allows surgeons to conduct life-altering and medically unnecessary surgeries on infants with variations in their sex anatomy simply to address the anticipated discomfort of others rather than the child’s health and well-being,” said Shannan Wilber, Youth Policy Director at the National Center for Lesbian Rights. “These practices perpetuate gender stereotypes and may not reflect the child’s choices when they are old enough to participate in the decision. NCLR is honored to stand with the intersex community to support their autonomy and dignity.”

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Equality California is the nation’s largest statewide LGBTQ+ civil rights organization. We bring the voices of LGBTQ+ people and allies to institutions of power in California and across the United States, striving to create a world that is healthy, just, and fully equal for all LGBTQ+ people. We advance civil rights and social justice by inspiring, advocating and mobilizing through an inclusive movement that works tirelessly on behalf of those we serve. www.eqca.org

interACT: Advocates for Intersex Youth affects nearly every piece of policy that touches intersex issues in the United States. Committed to ending stigma against variations in genitalia and other sex anatomy, interACT has over 15 years of experience driving legal, legislative, media, and youth initiatives that elevate the voices of intersex people. Learn more or donate to our work at https://interactadvocates.org/

The National Center for Lesbian Rights (NCLR) is a national legal organization committed to advancing the human and civil rights of the lesbian, gay, bisexual, transgender, and queer community through litigation, public policy advocacy, and public education. Since its founding, NCLR has maintained a longstanding commitment to racial and economic justice and the LGBTQ community’s most vulnerable. http://www.nclrights.org