Assembly Resolution No. 432

BY: M. of A. Seawright

MEMORIALIZING Governor Andrew M. Cuomo to proclaim
October 26, 2021, as Intersex Awareness Day in the
State of New York

WHEREAS, The State of New York takes great pride in recognizing
official days established to increase awareness of serious issues that
affect the lives of all New Yorkers; and

WHEREAS, This Legislative Body is justly proud to memorialize
Governor Andrew M. Cuomo to proclaim October 26, 2021, as Intersex
Awareness Day in the State of New York, in conjunction with the
observance of National Intersex Awareness Day; and

WHEREAS, Variations in physical sex characteristics, and intersex
traits, are umbrella terms used to describe a wide range of natural
bodily variations in traits including genitals, gonads, internal
reproductive organs, hormone function, and chromosomal patterns; and

WHEREAS, Beginning in the 1950s, physicians in the United States
began performing normalizing surgeries on infants with variations in
their sex characteristics, often referred to as intersex, in an attempt
to force them to conform to what these physicians perceived as typical
male and female bodies; and

WHEREAS, These irreversible interventions include infant
vaginoplasties, clitoral reductions and recessions, procedures to
relocate a functioning urethra, and removal of gonadal tissues, which
continue to this day in New York State even though such surgeries may
result in lasting harm and have been deemed human rights violations by
multiple international agencies; and

WHEREAS, These surgeries are most often performed before a child
reaches the age of two, despite no urgent medical considerations that
would require immediacy in the majority of cases, meaning the individual
is needlessly deprived of the opportunity to decide whether these
procedures are right for them; and

WHEREAS, There is evidence these surgeries can cause severe
psychological and physiological harm when performed without the informed
consent of the individual; and

WHEREAS, These harms, which often last a lifetime, may include
scarring, chronic pain, urinary incontinence, sterilization, loss of
future sexual sensation and function, recurring complications requiring
repeated follow-up surgeries, depression, post-traumatic stress
disorder, suicidality, and incorrect gender assignment; and

WHEREAS, These interventions are often justified by cultural
assumptions about appropriate appearance and function of another
person's body, and adults' fears that children with variations in
physical sex characteristics will be ostracized by peers and/or will
grow up to be LGBTQ; and

WHEREAS, Parallels exist between these nonemergency surgeries on
children with variations in their sex characteristics and the practice
of conversion therapy suffered by LGBTQ youth, as well as the
performance of medically unnecessary interventions on disabled
populations not based on individual health and well-being; and

WHEREAS, Being born with variations in one's sex characteristics is
not a flaw or shortcoming, yet intersex people and their families report
difficulties accessing competent medical care that centers the child's
well-being and self-determination and does not emphasize surgery or a
regimen of hormones before the individual is able to participate in
these decisions; and

WHEREAS, This difficulty is echoed by the Fenway Institute's recent
guidance on intersex-affirming care, which acknowledges that "[o]ften,
families feel pressured to consent to surgeries on their child without
being given sufficient mental health counseling, peer support, or
information on alternatives to surgery."; and

WHEREAS, Experiences of pathologization and stigma in medical
settings were reported by many individuals and their families in
interviews conducted by Human Rights Watch, including one mother who
explained: "I just wish someone had said: 'she's OK, she's perfectly
healthy, there's nothing wrong with her, surgery can happen later and
here are some people who have been through your situation.'"; and

WHEREAS, The United Nations Special Rapporteur on Torture and Other
Cruel, Inhuman or Degrading Treatment or Punishment explained in 2013,
"Children who are born with atypical sex characteristics are often
subject to irreversible sex assignment, involuntary sterilization,
involuntary genital normalizing surgery, performed without their
informed consent, or that of their parents, 'in an attempt to fix their
sex,' leaving them with permanent, irreversible infertility and causing
severe mental suffering."; and

WHEREAS, The World Health Organization explained in 2015 that
children born with variations in their sex characteristics have been
"subjected to medically unnecessary, often irreversible, interventions
that may have lifelong consequences for their physical and mental
health, including irreversible termination of all or some of their
reproductive and sexual capacity ... Human rights bodies and ethical and
health professional organizations have recommended that free and
informed consent should be ensured in medical interventions for people
with intersex conditions, including full information, orally and in
writing, on the suggested treatment, its justification and
alternatives."; and

WHEREAS, Physicians for Human Rights has "call[ed] for an end to all
medically unnecessary surgical procedures on intersex children before
they are able to give meaningful consent to such surgeries."; and

WHEREAS, Human Rights Watch concluded in its in-depth 2017 report
that these surgeries are "often catastrophic, the supposed benefits are
largely unproven, and there are generally no urgent health
considerations at stake. Procedures that could be delayed until intersex
children are old enough to decide whether they want them are instead
performed on infants who then have to live with the consequences for a
lifetime."; and


WHEREAS, Three former Surgeons General of the United States agreed
that these surgeries can cause "severe and irreversible physical harm
and emotional distress" and "violate an individual's right to personal
autonomy over their own future," "clearly infring[ing] on the child's
right to physical integrity, preservation of sexual and gender identity,
and procreative freedom."; and

WHEREAS, The United States Department of State has commemorated
Intersex Awareness Day by recognizing the harm of these surgeries,
stating that "at a young age, intersex persons routinely face forced
medical surgeries without free or informed consent. These interventions
jeopardize their physical integrity and ability to live freely."; and

WHEREAS, The largest intersex patient support group in the United
States, InterConnect, has called for a delay of all decisions regarding
non-urgent procedures on children with variations in their sex
characteristics until the individual can participate in the decision;
and

WHEREAS, The largest advocacy organization in the United States
dedicated exclusively to advancing the rights of people born with
variations in their sex characteristics, interACT: Advocates for
Intersex Youth, has likewise called for laws and policies that ensure
decisions about surgeries to "normalize" sex characteristics that are
not medically urgent in early childhood are delayed until the individual
can lead the decision; and

WHEREAS, The New York City Bar Association has explained in a 2019
report, "We advocate for the end of these unnecessary, nonconsensual,
and irreversible surgeries inflicted upon intersex people and support
the right of parents to receive accurate and timely information about
medical interventions that they currently may feel pressured into
consenting to without a full understanding of the life-long
ramifications and known risks of these surgeries."; and

WHEREAS, Those subjected to non-consensual interventions at a young
age frequently express despair over the fact that they were unable to
make these decisions for themselves and hope that future generations
will not be subjected to these procedures, such as an individual who was
forced to undergo "normalization" surgery in New York City: "I think our
advocacy is informed by not wanting young people to go through this
unnecessarily. I think we have a duty to prevent unnecessary trauma";
and

WHEREAS, Physicians who have treated intersex patients have
expressed remorse at the legacy of non-consensual surgery and revealed
that gaps in their training left them unprepared in the case of intersex
people, with a former NYC Health Commissioner explaining: "Twenty-five
years ago, while doing an emergency room shift as a third-year
pediatrics resident ... I met a patient who has been seared into my
memory. " [T]hey had gone through genital reassignment surgery as a
young child without their consent. After completing the medical history,
I tried to start the physical examination but didn't get very far. The
patient said, 'No offense, Doc, but I am not going to let you touch me.
I am tired of having residents parade through my room and my body to see
what it looks like to be the aftermath of intersex surgery done during
the '70s.' à What I learned that day was that decisions made by adults

out of ignorance and fear can leave lifelong physical and mental
scars."; and

WHEREAS, Intersex people who have had the opportunity to make their
own choices about pursuing or avoiding surgery are thriving, such as one
young person who was able to weigh the risks and benefits of surgery
when they were older instead of being forced to undergo the procedure in
infancy, who told reporters that for them, surgery "was the right
choice, but that's very much an anomaly for intersex people ... The
important thing was that I was old enough to make that decision for
myself."; and

WHEREAS, Individuals and their caregivers report not having been
told of significant risks relating to these interventions, including the
likelihood of follow up interventions based on high complication rates,
lifelong hormone replacement therapy, uncertain functionality, tissue
loss, loss of sensation, inflexibility of scars, and infertility, among
others; and

WHEREAS, Individuals born with variations in sex characteristics
must be afforded the same informed consent provided any other individual
prior to undergoing an irreversible medical procedure, including a
description of the treatment or intervention to be performed, any
necessary health care management or long-term follow-up care, a
description of any attendant discomfort and risks in the short term and
long term, an explanation of any benefits, an explanation of any
appropriate alternatives including delay or forgoing treatment, as well
an offer to answer any inquiries concerning the treatment or
intervention involved; and

WHEREAS, In the rare cases when the physical health of a child with
variations in their sex characteristics is threatened such that
intervention is immediately necessary to address a risk of harm and
cannot be safely deferred, all medically necessary treatment options
should remain available to ensure that the imminent physical danger is
addressed; and

WHEREAS, Interventions that alter the genitals, gonads, or other
internal sex organs of children with variations in their sex
characteristics too young to participate in the decision, when those
procedures both carry a meaningful risk of harm and can be safely
deferred, are the sole subject of this resolution; and

WHEREAS, New York must: serve as a model of competent and ethical
medical care and has a compelling interest in protecting the physical
and psychological well-being of minors, including intersex youth; oppose
all forms of prejudice, bias, or discrimination and affirms its
commitment to the safety and security of all children, including those
born with variations in their physical sex characteristics; consider
intersex children a part of the fabric of our state's diversity to be
celebrated rather than an aberration to be corrected; recognize intersex
children should be free to choose whether to undergo life-altering,
irreversible surgeries that carry high risks of harm when performed
without individual consent; and call upon health professionals to foster
the well-being of children born with variations in their sex
characteristics, and the adults they will become, through the enactment
of policies and procedures that respect their right to
self-determination and bodily autonomy by deferring medical or surgical

intervention until the individual is able to participate in
decision-making and providing affirming support to promote patient and
family well-being; now, therefore, be it

RESOLVED, That this Legislative Body pause in its deliberations to
memorialize Governor Andrew M. Cuomo to proclaim October 26, 2021, as
Intersex Awareness Day in the State of New York; and be it further

RESOLVED, That a copy of this Resolution, suitably engrossed, be
transmitted to The Honorable Andrew M. Cuomo, Governor of the State of
New York.