Including “I”

1. Including “I” Workshop on Intersexuality for service providers

2. Intersex South Africa • ISSA is a non-profit organization managed by Engender. Both organizations advocate on behalf and with intersex people while providing services for all intersex South Africans. • Intersex South Africa was founded in 2001 by local intersex activists and their allies. Since 2001 ISSA has been responsible for influencing and writing national legislation that affects all intersex South Africans.

3. What does the workshop want to achieve today? • Hopes to answer: • What is intersexuality? • How can you support intersex people? • How can you be an advocate?

4. Opening the Discussion on Intersexuality

5. MYTH BUSTING INTERSEXUALITY • COMPLETE THE FOLLOWING TRUE & FALSE EXERCISE....don’t worry no one will have to see your answers.

6. What is Intersex? • Intersexuality is best described as atypical congenital physical sexual differentiation. In most but not all cases, the atypical sexual differentiation takes the form of ambiguous external genitalia.

7. Intersexuality in South Africa • South Africa is believed to have amongst the highest population of intersex people in the world • The prevalence rate can be even higher than 1 in 500 people.

8. MYTH BUSTING • Intersexuality is NOT the same as transsexuality. • IF someone is intersexed it DOES NOT mean that they are born with both complete sets of female and male genitalia. • Genital surgery is NOT often medically necessary when an intersexed infant is born. • Intersexed people that have genital surgery as children that is not medically necessary often feel LESS “normal”. • Intersexuality IS COMMON however there is a great deal of stigma that prevents intersex people from identifying as intersex. • You CANNOT tell who is and who isn’t intersexed. • Interventions that focus on counselling and education for the family and the intersexed person ARE MORE effective than genital surgery. • Most intersexed South Africans DO NOT know they are intersexed. • Some intersex activists argue that a gender SHOULD be assigned to an intersex child in order to foster proper social development • EVEN though no one can see your genitals, intersexed people ARE discriminated against

9. Laying the Ground Work

10. Intersexuality vs. Transgenderism • Intersexuality is biological this means that people do not have genitalia that is typically male or female. • Transgenderism can refer to a wide variety of gender related issues. However, most transgendered people are biologically born with either male or female genitalia. • Many transgendered people may opt for consensual sex assignment surgery, whereas many intersex people reject genital surgery.

11. History of Intersexed people in South Africa • In the mid-1950s it became standard practice in the global North to surgically alter the ambiguous sex organs of intersex infants and children, and to do so as early as possible. • Many intersex people with ambiguous male genitalia had genital surgery performed to make them appear as female. • Surgical practice is based on John Money (USA) theories on the development of sexual identity • Main case study used was “John/Joan” case • 1997 medical evidence proved the theory to be wrong. • These revelations called the practice of imposing essentially cosmetic surgery on the sex-organs of intersexed infants and children radically into question. • In contrast to the United States, Britain and other metropolitan countries, where the practice of imposing surgery on the sex organs of intersexed infants and children is being questioned increasingly from within the medical profession itself, the practice seems to continue unabated in South Africa.

12. History continued... • In South Africa many intersexed South Africans live in rural areas, or socio-economically depressed townships. • Because of the secrecy surrounding intersexuality and genital surgery, many intersexed South Africans are un-aware that they are intersexed • In South Africa intersexed people are at constant risk of hate crimes and discrimination

13. Laws affecting intersexed people in South Africa... • Standard medical protocol continues to negatively effect all intersexed South African infants and children. • ISSA’s goal is to create official legislation that will make it illegal to perform non-consensual, non-medically necessary cosmetic surgery on intersex infants • Sex Description and Sex Status BILL B37 – 2003

14. Choice?

15. Sex Assignment Surgery... • Unnecessary, genital surgery is when a doctor attempts to biologically assign either male or female genitalia to an intersex child. • This practice was mainly based on John Money’s sexual development theories that relied solely on one case study, “John/Joan” that was never adequately followed up. • In 1997 Money’s theory was proven to be incomplete and false.

16. Health effects... • Unnecessary, non-consensual surgery leaves life-long emotional and physical scars. • People who have surgery performed on them typically have huge emotional consequences later in life and have attempted or contemplated suicide.

17. Alternatives to surgery... • Intersex activists advocate for a different approach that involves postponing surgery until an intersex child reaches puberty and can choose whether or not to have surgery. • Counselling and education for the intersex person and the family has proven to be the most effective way to ensure the psychological, emotional and sexual health of an intersex person.

18. SUPPORTING INTERSEX CLIENTS

19. What do intersex people want? • ASK!!!!! • What do they want? What do they need? How can you assist them? If you know your client is intersex, don’t assume they are coming to you for support on intersexuality.

20. Structural approach to counselling... • See the client as the expert of their own situation • Empower the client through education and support • Mediate, negotiate and advocate on behalf of your client but remember to always ask your client’s permission first. • Remember to check yourself at the door

21. How to be an advocate? • Keep open-minded to intersex people’s experiences • Believe your client • Keep updated on intersexuality. • Display posters that talk about intersexuality • Provide intersexuality resources • Educate everyone you can about intersexuality

22. Conclusion

23. INTERSEX SOUTH AFRICAwww.intersex.org.zaThank you for attending!