Transgender sexual mutilation

[jean-christophe Lurenbaum]

This thread is open to discuss sexual mutilation of transgender people.

For recent information, see this press release from the Darbon Institute and Transgender Victoria:

https://www.darboninstitute.org/trans_surgery_is_not_mutilation

which invites to sign this petition against transgender sexual mutilation

https://www.change.org/p/annastacia-palaszczuk-allow-legal-gender-recognition-without-invasive-surgery

"In the state of Queensland, transgender individuals are required to undergo invasive sexual reassignment surgery before they can legally change the gender on their birth certificate."

[jean-christophe Lurenbaum]

In solidarity, I suggest that the coalition promote not only the WWDOGA, but other events of importance to coalition members. For transgender and intersex people, the coalition could support ExisTransInter:

October - ExisTransInter (1997 wikipedia) annual event  "the march of Trans & Intersex people and their supporters. The demands concern the rights of trans and intersex people.

[jean-christophe Lurenbaum]

What is "sexual mutilation" in the case of transgender people, according to The Bodyguards' statutes?

• For the coalition, sexual mutilation is very specifically defined as “any modification of a sexual organ or sex characteristic carried out on an individual without their free and informed consent, and without medical necessity”.

• Mutilation is not limited to children (beware of the bias of many intactivists, especially Americans, who are used to neonatal circumcision only) or to sexual modifications practised by force: examples include VMMC or adult "phimosis" circumcision (Alex Hardy case). The central issue is the "conditions of consent", including the age at which consent becomes possible. Many intactivists believe that applying the "right to physical integrity" would solve the problem of sexual mutilation, especially for children, but this is not the case. Indeed, the various laws that exist in the world on the "right to physical integrity" rarely specify the age at which one can dispose of one's body for each of the possible interventions. It is the case law that sometimes gives details for this or that body modification. For example, cosmetic surgery to repair "ear separation" can be performed under the age of 10 in France, if the child so requests.

• The case of transgender people

  • A particular case of sexual mutilation, which is very specific to this population, is the obligation to undergo sterilisation in order to change one's legal gender. In France, for example, this obligation was abolished in 2016 only.

  • Another issue for transgender people is the conditions of consent, including the age of consent, to desired sexual body changes, as for any other body change (typically cosmetic surgery).

• It should be noted that in countries such as France, transgender adolescents have the right to undergo such body modifications, including of their sexual organs. This is a parameter to be taken into account in order to avoid that legislation prohibiting non-medically necessary circumcision below a certain age (typically 18 years) discriminates against transgender people who might perform sex organ surgery before that age.

All this explains why Droit au Corps' central demand is to open a public debate on the 'conditions of consent' to sex organ modifications, including the minimum age of consent. This age may not be the same depending on the social context and may have to be different for men, women and transgender people. On this question of the minimum age of consent, it is important not to give in to the easy paternalistic position that "protects" young people at the cost of their freedom.

Le jeudi 25 mars 2021 à 12 h 33 min 26 s UTC-4, jean-christophe Lurenbaum a écrit :

[Timothy John]

With male/female/intersex cutting, adults impose non-therapeutic interventions on a child in a process called "norming". These are efforts to "normalize" the child and make the child fit within societal expectations. With trans youth, it's my understanding that the "norming" they face is the withholding of gender-affirming therapeutic interventions (hormone blockers, body surgeries). This is done in an effort to keep the trans child within societal expectations by limiting their ability to escape the restrictive boundaries of being a "normal" (i.e., binary male/female) person and prohibiting them from making the transition into their true selves until after age 18, when it can be more difficult and problematic.

 

In my opinion, this is a paternalistic view, which is of course consistent (among some in the genital autonomy movement) with not letting boys decide on circumcision until after age 18 -- unless there's a medical need. And this is where circ differs from trans. Usually there will be no medical need to get circumcised before age 18. Usually it's just an aesthetic desire (think tattoos) or acquiescing to social pressure. As I understand trans issues, there is very much a medical need to allow trans youth to make these medical decisions earlier in life rather than later. Prohibiting them from making the transition until after age 18 subjects them to having to endure two puberties; a natural one in adolescence and another as an adult when they undergo hormone treatments to reverse the effects of the first puberty.

 

Also, men and women who were circumcised as children, as well as intersex adults subjected to childhood genital surgeries, might think of themselves as 'sexually mutilated' because the genital modification was forced upon them as children. As I understand it, trans people who undergo hormone blockade or body surgeries do not consider their modified bodies to be mutilated. Quite the opposite. In a troubling new development here in the US, conservative right wing legislators are moving to restrict doctors from helping trans youth with gender-affirming care. They claim that trans surgeries are 'genital mutilation' and should be prohibited.

 

Because of these differences, this could be an obstacle to us forming alliances with the trans community, unless we enter into direct dialogue with trans people on these questions. As I see it, the primary common ground that M/F/I share with Trans is one of 'Genital Autonomy' (not 'Sexual Mutilation'). I believe it would be helpful for us to invite a trans person to write an article explaining the reasons where trans issues can be different from M/F/I genital cutting, but also where there are the things we can agree on and the principles upon which we can work together to build a mutually supportive alliance.

[Timothy John]

Today I asked Brian Earp for feedback on my thoughts that I recently posted here. He said that he believed my thoughts are on the right track and summarized it very succinctly thusly:

"Trans interventions are ideally autonomy promoting & strongly desired by the individual after deep reflection; male/female/intersex surgeries are autonomy undermining because they are done before the person has formed autonomous preferences for how they want their body to be."

[jean-christophe Lurenbaum]

Thank you Tim for your very interesting post with which I largely agree.

However, there is one point I don't quite understand, when you say: "Because of these differences, this could be an obstacle to us forming alliances with the trans community". The international coalition has never said that the legal age limit for non-medically necessary male circumcision should be 18 (nor does the "right to physical integrity" say so): the same age could therefore be used for male circumcision as for transgender body modification. Droit au Corps also recommends introducing the age of 13 in the debate on the conditions of consent for male circumcision. See this post for more details and a comparison between the ages of 13 and 18, and why debating the age of 13 might encourage a more rapid abandonment of male circumcision worldwide.

It should be noted that WWDOGA advocates for 'genital autonomy' by focusing its discourse on 'children': this suggests that WWDOGA supporters agree that children should be free to change their sexual characteristics and organs before the legal age of majority (which is 18 in most countries in the 21st century). 

[Timothy John]

I do not yet have a firm position about an appropriate age of consent for genital modifications, but here is the direction my thoughts are taking me.

On the one hand, there are some in the US movement who argue that NO ONE (whether younger or older than 18) should be permitted to alter their genitals for non-medical reasons. These are who I call the "genital integrity" activists. They hold a rather un-nuanced and absolutist position. To me, this is paternalistic and anti-autonomy and is a doomed strategy.

On the other hand, there are those who say it's OK to modify your genitals for non-medical reasons, but only after the age of 18. They think of themselves as supporting "genital autonomy" but seem to believe that true autonomy can only be exercised after age 18.

In the UK there is the concept of Gillick Competence where a child might be considered competent enough to consent to their own medical treatment. Whether this has relevance to non-therapeutic surgeries like male circumcision for reasons of aesthetics or social pressure I do not know.

Perhaps it's worth discussing whether there is a need for a nuanced two-track "position statement", not just for ICASM but for ALL organizations that claim to support "genital autonomy". Such a two-track statement could endorse voluntary therapeutic (gender-affirming care) for trans youth who are well under the age of 18, as well as for any medically required genital alteration of male/female/intersex people. At the same time the statement could oppose all NON-voluntary, NON-therapeutic genital modifications of boys, girls and intersex people under the age of 18, but still support VOLUNTARY non-therapeutic genital modifications of boys, girls and intersex people under the age of 18 if they can demonstrate "Gillick Competence".

In the US (at least), I do not believe there is any legal restriction on a person under the age of 18 from consenting to male circumcision or to female genital cosmetic surgery, or to gender-affirming surgery (e.g., breast removal in the case of female-to-male transition).

If ICASM adopted a two-track policy this would be consistent with the reality of what's happening in real life and it would be consistent "across the board" with the concept of genital autonomy.

[v.sch...@gmail.com]

Thanks, I absolutely agree with Brian Earp.
FGM/MGM/IGM are FORCED onto children. 
NOBODY EVER has forced trans* surgeries on adolescants. In the contrary, these people fight for their lives and are often deprived of medicial treatments they need to survive. 

I absoluely agree with the Darbon Insitute press release as well. Thank you. 
It is very important to strictly seperate this areas. Apart form the point that trans children can be affected by FGM/MGM/IGM in childhood that makes it much more difficult later if they wish surgeries adapting to their gender conciousness.
Please don't use the word "transgender mutilation" if self determined informed bodily gender adjustment is meant. 

Warmly

Victor

[Michael Winnel]

The trans issue is a very complex and sensitive area, and in some respects falls outside of the coalitions jurisdiction ( a jurisdiction which focuses on protecting people, mainly children, from forced cutting of their genitals). Our jurisdiction does not yet cover promoting cutting, such as in some trans cases. 

This issue also highlights the problematic nature with all terminology, and in this case with the term Genital Autonomy (GA). It highlights the shadow side of GA. On one side of the GA spectrum, GA mandates protecting all people from forced cutting. On the other side, GA promotes cutting via an individuals autonomous choice. This is potentially a shadow aspect. Many intactivists did not join the movement to promote cutting in any form, but rather to prevent forced cutting of the genitals - this does not mean they do not support trans matters, it simply points to trans complexities being a seperate issue, and one beyond the scope of their focus. 

Contrast this to intersex, and intersex issues fall exactly inside the coalitions jurisdiction. Eliana from ITANZ (Intersex New Zealand) spoke to this point during one of our meetings earlier in the year, illuminating the differences between the Intersex and Trans struggles, and highlighting that the intersex struggle is primarily one of protection from sexual mutilation (forced cutting), and not to be confused with Trans complexities such as "gender affirming surgeries", which is highly controversial, and needs more education within the coalition before assumptions are made about TBs jurisdiction/scope, or the consensus of the TB members. 

The DaC appeal to debate is critical in illuminating such matters, and this whole complex issue speaks to the importance of having the DaC debate about an age to consent etc. 

Additionally, the Trans issue has become very divisive in many communities such as academia and feminism, causing enormous schisms and rifts, as evidenced by the tensions and conflict in Terre De Femme over the issue, and the rise of the slur TERF" (Trans Exclusionary Radical Feminist) being used to divide academia/feminists. TB is at a fragile stage in its development, and barely survived a couple of crises - it is critical we work within our limits and do not over reach into yet another crisis or area that is conflict prone until we have much clearer vision and consensus.

Regards, Michael

Foreskin Revolution Australasia 

[kevinrba...@gmail.com]

I certainly support the Darbon Institutes perspective that Transgender reassignment surgeries are not mutilations as they are initiated with informed consent to resolve what could be considered a life threatening problem.

In addition I also support that transgendered persons should not have to undergo invasive reassignment surgeries in order to have their gender change legally. 

In Australia currently the approached applied concerning treatment for children and adolescence suffering from gender dysphoria is as per the 2018 guidelines developed by The Royal Children's Hospital Melbourne. 

1. They recommend counselling and support in social transitioning for prepubertal children.
2. For teenagers, puberty suppression with reversible hormone blockers could be initiated if they were experiencing “significant distress” with the onset or progression of pubertal development.
3. And if the patient wished to proceed with the transition, the next step would involve starting gender-affirming hormone therapy — but only once informed consent was obtained from both the adolescent and “ideally, but not necessarily” their parents or guardians.

The UK has recently delved deeper in the matter and this article gives a fairly comprehensive update on where things are currently given their high court rulings that determine under 16's are likely ineligible under Gillick to consent. 

Further rulings have determined that in the absence of Gillick competency consent could still be afforded by proxy, parent or guardian in some cases. 

(Perhaps one of our UK people could give greater detail)

In relation to the approach adopted here in Australia I do still hold some concerns in relation to administering "reversible" hormone blockers primarily because as the UK Supreme court pointed out these treatments are still considered experimental and not well studied. 

Having said all of that many young people have and do suicide and suffer terribly as a result of gender dysphoria so a variety of supports and interventions are absolutely critical. 

The Gillick Competency test although of English origin has been adopted in Australia, New Zealand, Canada and Scotland to a varying extents. 

The use of this competency test is not confined to consent for medical treatment and is also often applied in the following situations - 

• Children making decisions about their sexual activity
• Children deciding their living arrangements
• A child who wants to make a decision about the medical treatment or procedures that they receive
• Financial decisions such as making a will
• In some situations, Gillick competency can be assessed for marriage cases

How does this relate to capacity to consent to non clinical/medical or non therapeutic circumcision?  

My personal belief is that legal competency is not solely governed or determined by the magical number of 18 years of life and measures such as Gillick Competency exist for that very reason.

Some young people between the ages of 13 and 16 may very well hold the capacity to be considered legally competent in many elements of decision making and consent processes. This is already established in numerous countries. 

In Australia and New Zealand once over the age of 16 you are considered capable of affording consent to medical procedures and if under 16 you must prove that you are capable. 

This is the current standard here so if restrictions for consent to circumcision were applied this is the system that would likely be adopted under in my humble opinion.