SB 201 would ensure that people born with variations in their sex characteristics and genitalia are given the opportunity to provide informed consent before any medical treatments that could irreversibly affect puberty, sexual function, or fertility, including reducing a clitoris, creating a vagina, or removing healthy gonadal tissue.

 

California Senator Scott Wiener announces SB 201 alongside interACT staff, organizational supporters, and the next generation of Stanford Medical School students.

 

San FranciscoToday, Senator Scott Wiener (D-San Francisco) announced legislation to ensure intersex individuals—a term used often used by people born with variations in their sex characteristics, including genitalia—can provide informed consent before any medical treatments or interventions that could irreversibly affect their fertility or sexual function. Senate Bill 201 would not prohibit intervention when medically necessary. This long overdue measure will give individuals the opportunity to delay medically unnecessary, potentially harmful, irreparable procedures until they have the ability to make an informed decision for themselves. SB 201, at its core, is about giving people born with variations in their sex characteristics autonomy over their own bodies and lives. Acting is risky, while waiting costs nothing. Delay gives individuals and their families the most options, including access to future medical advances once the patient can understand their own risks.

Approximately 1-2% of people are both with variations in their sex characteristics, sometimes referred to as intersex traits. A subset of these variations are recognized at birth, while others may go unnoticed until later in life, if ever. Although a very small percentage of intersex infants may require immediate medical attention—for example some are born without the ability to pass urine—the vast majority are able to live rich, fulfilling lives without any modification to their genitals.

Human Rights Watch, the World Health Organization, and every other human rights organization to consider the issue has condemned the continued performance of these procedures. Dozens of United Nations entities have repeatedly condemned the practice of intersex infant genital surgery.  Not unlike the victims of LGBT conversion therapy, intersex individuals living with the results of non-consensual genital interventions often deal with the harmful emotional and physical consequences of medically unnecessary attempts at “treatment” for the rest of their lives.

Beginning in the mid-twentieth century, physicians began modifying the genitals of infants they considered atypical, even if the surgeries were purely cosmetic and not medically necessary. These treatments and interventions include infant vaginoplasties, clitoral reductions, and removal of gonadal tissues, and may result in extreme scarring, chronic pain, incontinence, loss of sexual sensation, post-traumatic stress disorder, and incorrect gender assignment. While a number of doctors continue to perform these often irreversible procedures in infancy based on the theory that they will help intersex people feel more “normal,” no research definitively proves that claim, and all major groups led by affected adults condemn the practice when performed without the consent of the individual involved.  

SB 201 builds on Senator Wiener’s Senate Concurrent Resolution 110, passed in 2018, which called on the medical community to delay performing medically unnecessary sex-assignment and genital “normalization” procedures until an individual can provide informed consent. The resolution was the first of its kind in the nation, and if passed SB 201 would make California the first state to mandate intersex patient participation in decision-making before procedures such a clitoral reductions are performed.

SB 201 is co-sponsored by interACT, Equality California, the American Civil Liberties Union of California, and is also supported by Human Rights Watch. It is co-authored by Senator Jim Beall (D-San Jose), and Assemblymembers David Chiu (D-San Francisco), Todd Gloria (D-San Diego), Kevin McCarty (D-Sacramento), Phil Ting (D-San Francisco), and Bill Quirk (D-Hayward).  

The bill was officially introduced on January 28, and will be set for a committee hearing in the coming months.

Full bill text can be found here.
Press conference video can be found here.

Background Information

Quotes

“SB 201 preserves options for families of children born with natural variations in sex characteristics and genitalia. Drastic cosmetic procedures, like reducing a clitoris or creating a vagina for an infant, have not been proven beneficial, compared to delaying for the individual’s informed consent—acting has high stakes, while waiting costs nothing,” said Kimberly Zieselman, Executive Director of interACT: Advocates for Intersex Youth, an intersex woman herself affected by the surgeries. “Attempting to erase these natural differences perpetuates a message of shame, stigma, and homophobia. Medicine evolves alongside social acceptance, and this bill sends a clear message: there’s no rush to perform these surgeries on infants. interACT is proud to be a part of this historic human rights effort. ”

“When my daughter was born in 2012 with an intersex condition known as Congenital Adrenal Hyperplasia, we faced intense pressure to consent to cosmetic surgeries to reduce the size of her clitoris and create a vagina for heterosexual intercourse. I was surprised and angered by the fact that some did not agree that delaying cosmetic surgery until our daughter could decide for herself was the only ethical choice,” said Eric Lohman, a parent, author, and PhD in Gender Studies.

“Everyone deserves autonomy about who they are and what medically unnecessary surgeries they undergo,” said Senator Wiener. “This legislation allows individuals to choose for themselves if and when they undergo life-altering medical procedures. Parents and doctors have a critically important role to play in the health and well-being of their children, but we should not deprive individuals of the right to choose whether to undergo invasive surgeries that are cosmetic, medically unnecessary, and associated with long-term permanent health consequences. It’s particularly important to allow individuals to make their own healthcare decisions when a medical procedure makes potentially irreversible decisions about a person’s gender assignment – a decision that each person should be able to make on their own. I look forward to working with our broad coalition of intersex advocates, medical professionals, LGBT advocacy organizations, parents, civil rights organizations, and affected individuals to pass this important human rights legislation.”    

“For too long, our society has denied intersex children and their families the ethical, compassionate health care they deserve,” said Equality California Executive Director Rick Zbur. “This is a critical human rights issue – and it’s one on which California should be leading the way. We’re grateful to Senator Wiener for his leadership and look forward to once again sending a strong message of support to intersex Californians.”

“Instead of forcing conformity, we should celebrate our differences,” said Elizabeth Gill, Senior Staff Attorney with the ACLU of Northern California. “We must allow intersex individuals to embrace their identities and bodies, and to articulate who they are before doctors perform risky, irreversible, and medically unnecessary surgeries.”

Tweets

Bill hashtags: #SB201 and #DelayIsOkay
Bill sponsors to tag: @interact_adv, @scott_wiener, @eqca, @aclu_cap (California policy account specifically)

  • California’s #SB201 preserves options for children. Drastic cosmetic procedures, like reducing a clitoris or creating a vagina for an infant, are not beneficial vs delay for individual consent. Acting has high stakes, while #DelayIsOkay. —@interact_ADV
  • Like with LGBT conversion therapy, intersex people deal with the lifelong emotional and physical effects of attempted “correction” via infant genital surgeries. California’s #SB201 says #DelayIsOkay. 
  • For too long, society has denied intersex children and their families the ethical, patient-focused health care they deserve. California’s #SB201 says #DelayIsOkay. 
  • For children born with natural differences in genital appearance, #DelayIsOkay. Delaying cosmetic surgery until an individual can understand their own body and risk tolerance preserves options for kids and families. We support CA’s #SB201.

Graphics and Video

Free for use on social media.
Graphics courtesy of the ACLU of California
Video courtesy of interACT and Senator Wiener’s office

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Credit to: Eler de Grey
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Senator Wiener announces SB 201, a bill to affirm intersex human rights, in San Francisco.

interACT’s Director of Communications, Hans Lindahl, speaks on cosmetic genital surgery’s impact on the intersex community.

interACT’s Director of Communications, Hans Lindahl, speaks on California’s SB 201.

Stanford Medical Students Marija Kamceva and McKenzie Eakin speak on future doctors acknowledging wrongdoing and working together with the intersex community to center individual informed consent.

 

Senator Wiener responds to questions on SB 201, a bill to affirm intersex human rights, in San Francisco.