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CIRCULAR 7, 2016: A STEP BACK IN THE FIGHT FOR THE HUMAN RIGHTS OF INTERSEX PEOPLE IN CHILE. By Laura Inter and Hana Aoi

CIRCULAR 7, 2016: A STEP BACK IN THE FIGHT FOR THE HUMAN RIGHTS OF INTERSEX PEOPLE IN CHILE.

By Laura Inter and Hana Aoi

Special thanks to Dr. Eva Alcántara, who collaborated in the revision of this article.

 EN ESPAÑOL

Laura Inter is an intersex activist born in the 80s, since 2013 she runs the Brújula Intersexual project, which offers support and information to intersex people and their families. Laura was diagnosed with Congenital Adrenal Hyperplasia (CAH), and born with intersex genitalia (also called “ambiguous genitalia”), she was treated outside the public healthcare system and her body was not subjected to surgeries, maintaining her body integrity.

Hana Aoi is a Mexican intersex activist born in 1981. She was subjected to three different and totally unnecessary surgeries in her childhood, in which her gonads were removed and a vaginoplasty was performed. Her intersex variation was known as true hermaphroditism. Today the term DSD ovotesticular is more in vogue; Hana disagrees with the use of any of those stigmatizing nomenclatures. This variant occurs when there is ovotesticular tissue in at least one gonad (called ovotestis, pl ovotestes).

Circular 7

Summary:

On August 23, 2016, the Chilean Ministry of Health issued Circular No. 7, 2016, which invalidated Circular No. 18, 2015, which had been highlighted for demanding a cessation of irreversible and unnecessary surgeries and medical treatments in intersex children.

Amongst the most regrettable aspects of this new Circular is the adoption of a pathological language to refer the variants of sexual characteristics, under the term Disorders of Sex Development, as well as a generalization of such variants in scenarios where there are risks to the person’s health that must be taken care of, justifying again the medical interventions in which the patient is put aside and his/her human rights overlooked.

Due to this tendency to generalize and focus only on vague clinical aspects, without support for long-term results that validate them, and ignoring the numerous testimonies of adults with intersex bodies that were intervened in their childhood, as well as the appeals from activists and local and international human rights organizations, is that we feel with the moral obligation to denounce in the following article the errors of Circular No. 7, 2016, in order to expose how the assumption of this practice implies a setback, because it has been highly questioned for more than twenty years around the world, and even the international medical community itself has been forced to rethink due to its questionable aspects.

DOWNLOAD FULL ARTICLE (PDF)

Download Circular 18 (English translation)

Download Circular 7 (English translation)

Download Circular 18 (original in Spanish)

Download Circular 7 (original in Spanish)

Article: How was Circular 7 of the Ministry of Health of Chile born? By Camilo Godoy (Spanish)

 

 

 

 

Progress: A first look at the Ministry of Health Protocol for the provision of health care services for the LGBTTTI community (with a focus on the intersex-related parts).

Progress: A first look at the Ministry of Health Protocol for the provision of health care services for the LGBTTTI community (with a focus on the intersex-related parts).

by Hana Aoi

EN ESPAÑOL

Originally published in Spanish on June 25, 2017.

On June 24, 2017, the head of the Ministry of Health of Mexico, José Narro Robles, M.D., presented the document entitled: Protocolo para el acceso sin discriminación a la prestación de servicios de atención médica de las personas lésbico, gay, bisexual, transexual, travesti, transgénero e intersexual y Guías de atención específicas. (Spanish for Protocol for non-discriminatory access to the provision of healthcare services for Lesbian, Gay, Bisexual, Transsexual, Transvestite, Transgender and Intersex people and Specific Care Guidelines.) This work is the result of an intense collaboration between authorities of the ministry, academics, medical specialists, activists of the communities that make up the LGBTI community and human rights experts.

During the presentation, the minister stressed that “only with institutions aligned to the unavoidable respect for human rights, healthcare free of discrimination can be guaranteed.” He also appealed to the staff of the National Health System (that is, all health and social security institutes, federal and state, which together provide medical coverage to most of the Mexican population) to “know and operationalize these guidelines and comply with the provisions of Article 4. of the Constitution of the United Mexican States, which mandates that everyone has the right to health protection, and it is the responsibility of the federal and state authorities to set mechanisms to guarantee access to health free of discrimination or exclusion, in accordance with the specific needs of each population group. ” (The emphasis is mine)

From this space, we celebrate the progress of the Mexican State in recognizing the particular problem faced by intersex people who are intervened by medical services. This understanding starts from the definition of the term “sex” provided in the Protocol, since it goes beyond typical binary definitions, takes up the social factors involved in the understanding and classification of sex, but also comprises the diversity of biological factors that define the body of Intersex people at birth. Within the definition, the following fragment stands out, which cites the text of Julie A. Greenberg, Intersexuality and the Law. Why Sex Matters (2012):

Intersex people evidence that, biologically, there are not only two options for the various factors [that contribute to the determination of a person’s sex]. There are people, for example, with a different chromosomal sex. […] Intersex people demonstrate the limitations of creating these categories: genitals can say little of a person’s sex. (Emphasis mine)

The protocol is based on a set of guiding principles, which must serve as a criterion of medical practice, and which are fundamental to the exercise of an observant practice of human rights. From our perspective, there are three principles in this list that stand out: autonomy (“conviction for respect of the individual’s ability to act freely and make decisions according to his convictions and beliefs”); beneficence (“respect for their fundamental rights”); and non-maleficence (“imperative to do no harm”, known in the medical-legal language as primum non nocere).

The next address of the protocol to the problems faced by intersex people comes in the section about care of children and adolescents. The term variations in sex differentiation (a term that has been coined by the Ministry to refer to variations of sexual characteristics at birth, which gives rise to a non-pathological interpretation, and which in itself constitutes one of the main merits of the document) is introduced. It acknowledges that children and adolescents are “individuals in the process of development” and that, because of their characteristics, “may require specific attention”. This attention, however, does not seek to normalize the body of the individual. In fact, the protocol establishes that the function of the multidisciplinary team is to advise during the process of sex assignment, without forcing the acceptance of any treatment or surgical procedure; rather, the objective of this counseling is to guarantee the right to the (legal) personality of the newborn (“their right must be guaranteed … by assigning the gender for their legal registration”).

The main feature in the subject of care for intersex people is found in the Specific Care Guideline, entitled Guía de recomendaciones para la Atención de Intersexualidad y Variación en la Diferenciación Sexual  (Spanish for Recommendations Guide for Care of Intersex and Variations in Sex Differentiation), pages 36-42. It is an innovative guide, which, to be understood, must be read within the local (and regional) context. The Mexican reality, immersed in a historical conservatism that comes from convictions and dogmas based on the Christian faith (especially in the Catholic Church), is packed of stereotyped notions on what defines an individual as a man or woman (making no room for anything in the middle), as well as the social role that is expected of the sexed individual, and what his/her essence and actions express of him/herself, but also of his/her parents and immediate family. In this demanding context, it is understandable that, in order to respond to the emergency that our intersexed bodies represent to society, Mexican medical practice has implemented the protocol of care originated in the US for more than half a century. This practice allowed, in the eyes of the parents of intersex people, the assimilation of the individual to society. The problem with this approach is that it ignores the individual’s self-interest, sacrificing the possibilities of his/her body to the pressure of social structures, intolerant to any difference in sex configuration, structures that are based on fears, anxieties and fantasies. However, for some years to date, members of the Mexican medical community have begun to raise a reasonable doubt about the pertinence of continuing the practice inherited by their predecessors. For example, in 2009 a physician from one of the most renowned high-specialty hospitals in Mexico City, home to one of the major intersex intervention clinics, was questioned about whether such interventions were necessary. His response was that it was difficult to stop doing them, because “the cultural level [in the country] is very narrow: we are either ‘A’ or ‘B'” (Rea Tizcareño. Intersexuales: la notable excepción a la regla, La Jornada, May 7, 2009). This reflects an understanding of the difficulties of the Mexican context, but it also suggests that many physicians in position of taking action are no longer convinced that the current approach is adequate, that is: a person’s sex characteristics don’t need any medical intervention. Change has to take place at the social level.

The Recommendations Guide… acknowledges the questioning of the current medical approach and procedures implemented since the 1950s: “These medical interventions, which are regularly oriented towards the use of genital surgery in children, are currently questioned and have come to be categorized as ways of medical abuse”, which is a clear reference to the Yogyakarta Principles of 2008 and the joint document of UN agencies on the elimination of forced sterilization, coordinated by WHO in 2014. In another paragraph, and referring to the second hearing of the IACHR of March 20, 2017, it states: “The configurations and forms of intersex bodies previously considered malformations can now be assimilated as possible expressions of the variability inherent in human life” (emphasis mine). In this sense, the Guide recognizes that “human rights recommendations […] that have been set out in recent years” must be also integrated to the discussion.

Maybe the main merit of this Guide is its acknowledgement in the necessity of medical practice to reflect on itself from the lens that represent the strong judgment of current procedures, judgment that relies in the testimonies of intersex people who have risen their voices to claim their human rights and those of future generations.

In this sense, there are key values ​​of clinical action urgent to be brought into daily practice. This guide brings hope to the possibility. First, it recognizes the need to provide full information to parents and individual, and the importance of open and complete communication to mitigate parental uncertainty. This brings us to another point: consent. Consent is no longer solely in the hands of parents. The recommendation is now to delay any procedure until the very individual is able to decide (an example of this is the indication of stopping vaginoplasty in girls until “maturity and awareness necessary to request and consent to permanent modification procedures” are available). This translates into a recognition of bodily autonomy and self-determination. By involving the individual (child or adolescent) in the discussion about the pertinence of the procedures, and the times in which they got to be carried out, the way is paved for mitigating secrecy and stigma to a minimum, in favor of psychological development with less prejudice. The need to break with stigma demands the inclusion of peer support groups (this in order to provide a sense of belonging), and the accompaniment to parents to reduce the degree of anxiety and give way to their concerns, from a positive attitude towards bodily diversity. Only in this way can we in addition guarantee respect to the physical integrity. The guide goes further: each case is particular, and as such, admits that it is impossible “to unify processes that are in themselves different.” For this reason, while there’s a stress on safeguarding the rights to bodily autonomy and making decisions before “decisions involving irreversible changes”, surgical procedures are restricted to cases of newborns where “life or functionality of people is at risk”. This covers conditions encompassed under the broad definition of intersexuality, such as bladder exstrophy, where intervention might be justified.

For all the above, the mere publication of the Guide… represents an honest and promising effort. The fact that the Ministry of Health decided to assume a new paradigm, oriented to accept that reality is diverse and not restrictive, lays the grounds for a work that implies the sensitization and training of providers of health services; but it also demands that all of us, parents, educators and civil society in general, get to build spaces more open and tolerant, that promote the possibility of a fulfilling life.

Change will be gradual. Setbacks are to be expected. Resistance to change has been the constant of any social process. But we are on a path where there is no going back. This Protocol and the Care Guide represent clear, concrete hopes that it is possible to dialogue and build with the medical community in favor of a better future for others, for all. We can not correct the mistakes of the past, but here’s a chance to work for a fairer present for everyone.

Press release from the Mexican Ministry of Health (in Spanish).

(Last update: July 11, 2017)

 

Submission on the Yogyakarta Principles: Human rights issues and perspectives from the experience of the intersex community in Mexico.

*Submission on behalf of Brújula Intersexual for the review on the tenth anniversary of the Yogyakarta Principles, a collaboration between Laura Inter (Brújula Intersexual) and Hana Aoi (Vivir y Ser Intersexual)

Call for submissions on the Yogyakarta Principles

yogyakarta

Human rights issues and perspectives from the experience of the intersex community in Mexico.

In regard of the tenth anniversary review of the Yogyakarta Principles, we the members of the Brújula Intersexual project submit our perspective on the main human rights issues and demands from the experience of the intersex community in Mexico, as well as our suggestion on how the Principles should be supplemented to duly attend such issues, supported on the current state of international law and on recent legal developments that have taken place in different countries that serve as example and could provide guidance to other countries in order to create legal frameworks and law enforcement policies to ensure the observance of human rights for the intersex community.

Note: following the current intersex activists’ recommendation on the use of inclusive pronouns for English language on gender identity, we use “they”, “their” and “them” for a single individual.

The Principles and human rights issues of intersex people.

Forced medical procedures.

Intersex people, specifically when they are children (children as defined by the Convention on the Rights of the Child), are particularly vulnerable to unnecessary, irreversible and lifelong harmful practices due to stereotypical notions that bind gender and sex characteristics. Given that a child’s opinion is rarely asked nor voiced even when it’s their own body that is at stake, it’s their parents and practitioners’ beliefs on how a human body should look like that give way to unnecessary and irreversible medical procedures on the sex characteristics of intersex children in their early childhood.

While the Principle 18 already states that no person should be forced to undergo any kind of harmful medical practice on the basis of cultural stereotypes, we believe it should be supplemented to reflect the fact that health professionals shouldn’t perform any medical procedure by imposing (“bullying”) the child’s parents their personal notion of gender and sex characteristics, which is often a reason why parents consent to these practices. Furthermore, Principles 28 and 29 should include intersex people as subjects of the right to remedies and the obligation of States to prosecute violations to the right stated in Principle 18.

On the application of human rights law in Chile.

It’s relevant to mention on this subject the achievements attained in Chile in December 2015, when a public policy known as Circular 18, developed by the Chilean National Council for the Children, was issued by the Chile Health Ministry. This document states not only that all normalising medical treatments on intersex children should be stopped, but also that the care of every case won’t rely only on physicians or specialised teams, but also on the very Health Ministry who, on behalf of the State (as stated by the Committee on the Rights of the Child), will follow-up what happen to them. This is a fine example of a policy that acknowledges the respect of human rights of intersex people, but also an example of a law instrument issued from a government agency (Godoy, 2016, in Informe Anual sobre Derechos Humanos en Chile), and in that regard a tool for parents and allies of the intersex community to protect children from forced procedures.

Access to health services of the highest attainable standard.

Another common issue is the lack of adequate training of health professionals of every discipline and area when dealing with intersex people. Principle 17 calls all States to ensure that persons working in the healthcare sector are educated and trained to deliver their services with full respect of the person sexual orientation and gender identity (SOGI). However, we deem it should be supplemented in order to stop addressing intersex variants as pathological disorder, encouraging health professionals to acknowledge sex characteristics as something more complex than just a binary notion of sex and gender.

The same Principle should reinforce the right of children to voice their opinion regarding their own body. In this case, it should call States to ensure that any kind of medical procedure on the intersex child’s sex characteristics must be delayed until they can express their opinion and participate directly in the decision on whether or not undergo any procedure.

Finally, there’s a number of conditions associated to intersex variants, some of which are life-threatening. Principle 17 also should address the need of intersex people for adequate healthcare associated to their variant, but emphatically separating this need from any other medical procedure on their sex characteristics.

Legal documents.

There’s the case where birth certificates are denied to parents if they fail to deliver proof of the gender to be assigned (e.g. clinical studies, even undergoing sex-assignment procedures). Such display can be interpreted as discrimination based on the notion of sex and gender as inseparable.

While ideally removing the gender marker from legal documents or making it optional could be a solution, there’s still further steps to be taken first towards intersex visibility and awareness in order to avoid discrimination and stigma. We believe that the gender of assignment at birth should be decision of the parents, but no medical procedure on the child’s sex characteristics should be executed at all. Later in life, if the child’s opinion regarding their body involves also a reassignment in the gender marker, it should be available. Therefore, States must enforce this specific right in order to allow intersex people (and their parents when they are underage) to get all forms of legal documents without need of proving a gender based on sex characteristics.

Principle 3 already states that everyone shall be recognized before the law. However, it should be supplemented to reflect this obligation of the States.

On the application of human rights law in Australia.

In this matter, it’s worth to mention the case of the Sex Discrimination Amendment Bill issued in 2013 by the Australian Senate, which enabled the issuing of passports all across Australia without needing to specify a gender by having a third choice available in the form of an ‘X’ option. While we agree that such option is ground-breaking for intersex individuals whose gender identity doesn’t fall in the typical male or female classification, it should be cautiously considered because an ‘X’ option would stir the issue rather than being a solution for attaining identity documents in countries where discrimination for gender identity is still a matter of life or death. We believe the Principles should reflect the right to legal documents with no regard of gender identity, and with no obligation to state any gender at all, which is, in fact, a variation of the Australian case.

Letter to parents of children with congenital adrenal hyperplasia and “ambiguous genitalia”.

Letter to parents of children with congenital adrenal hyperplasia and “ambiguous genitalia”.

By Laura Inter

EN ESPAÑOL

Em Português

Translated by Laura Inter. Edited by Hana Aoi.

*For purposes of this letter I used the word “girls” and she/her pronouns for people with CAH and XX chromosomes, just to make it easier for parents to read. However, be aware that not everyone identify themselves as women and some might even prefer they/them pronouns.

madre-hija

It is common that doctors tell to parents of girls with Congenital Adrenal Hyperplasia (CAH) –and XX chromosomes– that their children were born with “genital malformation” or “ambiguous genitalia” and must be “fixed”, otherwise they will have infections, pain or other problems related to the menstrual flow. Doctors also say that because their children have a different body, they’ll end up rejected and isolated at school, among other social issues.

I have a body like that described by doctors. The first thing I want to say is that “ambiguous genitalia” is not a malformation. Your daughters were simply born with intersex traits, their bodies vary from the average body of a female, but they are NOT malformed women.

It isn’t a malformation because the genital forms depend on testosterone levels during gestation. All fetuses –despite their chromosomes– at some point during gestation have the same genital forms. When a fetus is exposed to “low” levels of testosterone, it develops typical feminine genital forms; on the other hand, if the fetus is exposed to “high” levels of testosterone, their genitals will take –so to speak –male appearance. It’s when they stay in an intermediate state in this process that doctors say babies are born with “ambiguous genitalia”. But actually there’s nothing wrong; it’s not a malformation because it’s part of a natural process that depends on testosterone levels. As simple as that.

It’s unknown if ALL people born with “ambiguous genitalia” will develop health problems related to their genitals, at some point of their lives; what I can say for sure is that in Mexico (where I do my labor), as well as in other places in Latin America and around the world, I’ve known many people with “ambiguous genitalia” who weren’t surgically intervened and they’ve grown into adulthood, and they are completely healthy, never having had any health problem related to their genitals. No pain, no problems with menstrual flow, no infections. I myself count among those people.

Of course, I can’t say that ALL people born with “ambiguous genitalia” will be healthy from their genitals throughout their whole lives, just as I can’t assure that ALL the people born with typically female or male genitalia will be healthy from their genitals throughout their entire lives. Neither can doctors make such statement, that ALL people who has undergone genital surgery are healthy from their genitals. In fact, the evidence tends to point to the opposite; I know many people who underwent genital surgery (particularly clitorodectomies and vaginoplasties) who, as a result, have suffered from many health problems. It is hard to conclude something definitive because, unfortunately, there are no follow-up studies in adults who were born with “ambiguous genitalia”, so even doctors don’t have a say on the long-term outcome of their procedures.

I don’t think it is appropriate to intervene the healthy body of a baby. Obviously if there are health problems in their genitalia, whether they are typically female, typically male or in between, medical intervention is recommended, but only to restore health. It isn’t coherent to intervene surgically healthy genitalia only for “cosmetic” reasons.

Surgeries not only cause psychological damage, these procedures also have physical repercussions. A clitoral reduction can leave your child with no sexual sensation or significantly reduce it. A vaginoplasty is not a “simple surgery”, as some doctors put it, but a major procedure in the body of a little child; in addition, after vaginoplasty, doctors will perform dilations, which mean they will have to introduce dilators (a sort of dildos) into the opening that they’ve created. The doctor will introduce them, maybe a nurse, or even they’ll propose that you do it. I have known people who have gone through such “treatment,” and it caused them psychological damage comparable to a rape experience.

Unlike doctors who treat your child, I believe she has a perfect body. If the problem is social rejection or isolation, don’t you think it’s more reasonable to act and make this society more tolerant and open instead of opting for irreversibly modifying the body of your little girl? Furthermore, you can educate your daughter to embrace and love her body as it is, not to teach her that every time society criticizes her body she should run to the surgeon. If she wants surgery, it must be up to her to decide once she’s older, getting all the information available and evaluating the possible consequences of those procedures. In support groups for parents and people with CAH, I have sadly found that many parents want to perform surgeries on their children to avoid criticism from their relatives or even from the nursery staff. To this, I say: people will always criticize everything, anything, and you can’t please everyone all the time, and least of all consenting surgeries in the body of the little baby in your care. A surgery will definitely solve nothing, nor will make your little girl “normal”, just because there is nothing abnormal with her. She is perfect and beautiful as she is, so love her as she is and teach her to accept and love herself as she is, because there’s nothing wrong with her or her body. Surgeries to shape of their genitals are medically unnecessary, they are just “cosmetic”, and yes, I put it in quotation marks, because the body of your daughter is already cosmetic as it is, it is beautiful.

Apart from this, there’s the point of the gender identity she will have when she grows older. That is something that no one but her can know while she’s growing. Your daughter may feel like a woman (female gender identity), but I also know people with CAH and XX chromosomes who feel like boys (male gender identity, they count for about 20 or 30 percent of people with CAH, as I’ve observed in my experience working with them), and it doesn’t matter if they undergo genital surgery or not. You also can’t anticipate what sexual orientation your daughter will have, it may be homosexual, bisexual or heterosexual. I have also found that many parents comment that they perform these procedures on their children to “enable” them to get a partner in the future, to avoid rejection of their possible partners, but regardless of the sexual orientation your daughter may have, the person that may became her partner must love her as she is, and if they don’t, why do you want a person with prejudice by her side? Why would your daughter want someone who will only will love her if she changes her body through surgery? The surgery is irreversible and only your daughter can take the decision modifying her body if she wants to, with full awareness of the consequences that these procedures may have.

I know from the testimonies I’d heard from some people with CAH, that surgeries can cause a number of negative consequences such as: problems with urination, lack of sexual sensation, scarring, pain when having intercourse, problems with menstrual flow; some people suffer from psychological trauma due to frequent genital examinations (sometimes they call several doctors to see the naked body of your little girl, and this is something that go on for years), and may suffer other traumas due to the vaginal dilations performed by doctors, nurses or by yourselves. In addition to the obvious risks that every person runs when exposed to anesthesia at any kind of surgery.

It is always wiser to teach your daughter to love herself as she is and wait for her to make the decisions that she believes are relevant to her own body, because it is HERS, NOT YOURS nor anyone else’s, and if her health is not at risk, no one have to irreversibly modify anything in her body.

I have a body similar to your daughter’s, with “ambiguous genitalia” (clitoris larger than what doctors arbitrarily consider “normal” and with an urogenital duct –the vagina and urethra ends in the same duct). Despite what doctors may say, I don’t have any health problems related to my genitals, I don’t have recurring infections, pain or problems related to my menstrual flow, and I enjoy sexuality without problems. Always bear in mind that sexuality isn’t synonym of penetration, and it can be enjoyed in many ways. I also have no social problems because I of my atypical genitalia, besides we don’t go naked in daily life. I’m 33 years old and I feel happy with who I am and with the body I have. If I had problems in the past, it was because of the humiliating treatment doctors gave me, denigrating language they used to refer to my body and the ignorance of my parents at the time.

Remember that one thing is the treatment for CAH, and another thing is that your daughter has genital variations; the treatment for CAH is important, it is important that your daughter take her medication if she needs it to be healthy, but genital variations, in the vast majority of cases, don’t involve health problems.

Broadly speaking, CAH occurs when the adrenal glands produce less cortisol than what the body needs, which is why doctors prescribe a variable dose of cortisol (the form of cortisol I was prescribed was Meticorten). Some need small doses, some higher, some only take it for a brief period of their life, others need it for all their lives, and I have met some people with CAH who never have taken cortisol and are healthy, so it depends on the person and the type of CAH (wasting salt or not wasting salt form, and even within these two the influence on health varies from person to person). It is important to mention that you have to be careful with the doses of cortisol administered, since I have found that many times a doctor prescribes a high dose of cortisol, inducing Cushing Syndrome (that is when the body is exposed to more cortisol than needed). The doctor always has to start with the minimum dose of cortisol, and if it isn’t enough, increase the dose, always in order to avoid Cushing’s. It is not typical of CAH, more usually is a result of a poor medical management or from a bad administration of cortisol doses.

As a conclusion, I wish to tell you that girls with CAH don’t need surgeries; they need loving parents, they need support and information, they need parents who are not ashamed of their children bodies and who love and teach them to love each other as they are. They need to meet people who have similar bodies, people who go through the same experience.

If you want psychological help, I can support you or put you in touch with local organizations that can listen to you, with real professionals that can help you and treat your child with respect, before making such an important decision. Take the opportunity to get in touch with us, my door remains open, for you and for any parent who is willing to offer their little ones a chance to love themselves as they are.

Anyone who wishes, can contact me through the email: intersexualmexico@gmail.com

Remember that you are not alone. And neither your child.

LGBTQ… I? By Hana Aoi

LGBTQ… I?

By Hana Aoi

EN ESPAÑOL

Opinion article by Hana Aoi, intersex person. Originally published in the blog Vivir y Ser Intersexual (link to the article in Spanish: https://vivirintersex.wordpress.com/2016/11/24/lgbt-i)

bandera-lgbti

In past November, during the training on intersex matters for personnel from the National Council for Prevention of Discrimination (Conapred by it’s name in Spanish, link to the council site: http://www.conapred.org.mx), an apparently unnoticed issue came up, something obviated before the event, that I deemed necessary to rethink. In Mexico City there’s an acronym of common use to cover and give visibility to all groups from the sexual diversity, LGBTTTI. No doubt, this has enormously helped many people to be aware of the existence of something called “intersex”. But is this approach actually informative? The original perception of many attendants to the training was that intersex was just another element of the diversity, thought as a sexual orientation or a gender identity. When the event was over, the understanding (I hope) was a different one, closer to reality: that intersex wasn’t a sexual orientation nor a gender identity; of course, these are aspects of the life of any person, and intersex people are no exception. We are undoubtedly related to the LGBTQ community in this regard. But there’s also to consider that our own struggle is to get respect of our human rights and acknowledgement of our body autonomy. Put in other words, it’s about being able to call the shots about the biological characteristics that make our bodies different, and the ground work to make that heterogeneity of the human body visible to society, as well as stopping any practice on our bodies as early as the moment of birth, because they’re aimed only to ease the social anxiety caused by the noncompliance of our bodies to the binary notions of sex and gender, and which only perpetuate fundamentally violent and irreversible procedures justified by a false rationalization: the one that claims that these procedures help to reduce the risk of stigma and discrimination.

The debate I’m proposing over the inclusion of the “I” in the collective acronym may seem pointless. It’s not, and I bring it to the table for a specific purpose.  Let’s begin by stating the obvious: for years, the LGBTQ community has made huge advances towards human rights acknowledgement and civil rights vindication, something that should be granted for any given person within a society that calls itself free and democratic. While I’m casting the shadow of my musings, I couldn’t possibly minimize these accomplishments, for I deeply respect the battles they’ve fought (and won) without me being there (I mean at the time when their claims were open for debate, because either I was too young or too ignorant). Indeed, we, the members of the intersex community share many aspirations as many of us can directly relate to the sexual diversity. For example, there’s a considerable number of intersex people who also are trans; so many intersex people identify as genderqueer or non-binary; there are too those who enjoy a full androgynous life experience; there’s even those who opt for surgeries willingly to transition their gender identity along with their sex characteristics, regardless of sexual orientations. And that too bind us to the LGBTQ community: many, whether embracing or not a label from a cisgender-point-of-view of their gender, experience freely and healthily their sexuality, sometimes assuming gender roles and sometimes not. So, yes: many intersex people are LGBTQ.

So, what am I ranting about?

It’s about our demand as a community. As LGBTQ, there are specific demands. But as Intersex, it’s all about human rights, those meant get full control of our bodies and the recognition of such rights even if we’re talking about minors (which is actually my particular view on this matter). This demand requires a very specific approach towards medical community and society in general, because it implies a redesign of medical practices and the changes and construction of legal frameworks that allow human rights to be respected and protected by law. Let’s recall that the intersex movement emerged as a response from the intersex people to the clinical approach of their bodies and beings (one that sadly lasts to the present day), promoted by sexologists, urologists and endocrinologists, among other medical specialists from the early 50’s (for a compelling reading on this and many other relevant intersex topics, look for Katrina Karkazis’ Fixing Sex). This approach has tried since then to “normalize” our different bodies, this is, to force them to fit in this typical definition that binds sex and gender, by the means of surgeries, hormonal replacement therapies and other clinical practices. But the struggle of the intersex community isn’t just to eradicate these practices (at least eradicate how they are performed without full consent of the interested person just because of them being underage), but also to transform the binary notion of sex and gender. This is one aspect from which I believe the LGBTQ movement could take benefit. Taking off the gender marker from official documents could be a good start. More realistic would be to make it easy for any person (trans and intersex) to change their gender marker in such records. But let’s dare dream: it also implies the possibility of challenging the concept of gender identity, regardless of biological traits, thus offering a liberating perspective for future generations who shouldn’t have to struggle to fit, since there would be nothing to fit in.

Having stated this, I think that it isn’t accurate to include intersex as an element of the sexual diversity. Not for the time being. Not as long as average people keep thinking of it as a gender identity or a sexual orientation. And this is why: while there’s a part of society who could care less about sexual diversity, and indeed accept it as such, there’s a need to get rid from the stigma that comes with homophobia and sexism in the heteronormative society we’re living in. The main purpose of intersex activism is visibility, visibility to their reality, their issues and claims. It’s lack of information, prejudices and fears in the minds of intersex children’s parents that make them go for the surgeries, taking away their kids liberty to choose, to voice their opinion about their own bodies. Sure, we, as grown-ups, can bite the bullet and answer back when we’re questioned. But children need to be protected from the very bigotry that parents fear. Fears and prejudices are expressed in phrases such as “I can’t deprive my kid from having a gender, because children can be cruel”. When we say this, we forget that it’s us who teach children to discriminate and bully, that it’s us who socially sanction such behaviour, that it’s okay to take the “perverts” and the “weirdos” apart, even when we say otherwise. By keeping on living in a social contract of control and domination we’re acknowledging discrimination and violence against what’s different. And this is what fuels the fears of parents of intersex children. So, if we can’t success at making intersex visible and intelligible first, and then we fail to address parents’ fears, then the association of the “I” with the LGBTQ community really won’t help kids and babies yet to be born. And parents will keep surrendering to their understandable fears and giving up their children to surgeons.

This is why I believe the “I” should stand out by itself, as long as it takes for people to get what intersex is. Even when it will still be associated to the LGBTQ community for the reasons stated above. It’s necessary that parents of intersex children first speak out their fears and confront their mixed feelings, and then embrace the diversity of humankind embodied in their kids. By stepping out we wouldn’t ignore the LGBTQ struggle, but we’d acknowledge the specificity of our demands and the way they must be addressed in order to make them happen.

 

A broken story. By Hana Aoi (mexican intersex person)

A broken story.

By Hana Aoi (E-mail address: aoihana.1981@gmail.com. Website: Vivir y Ser Intersexual)

EN ESPAÑOL

This is the English version of the original one published originally in Spanish in Brújula Intersexual as Historia rota.

hana-orquidea

It’s a sidereal abyss, an immense void of unbearable darkness and quietness. You can’t see nothing; you can’t hear nothing. Still, there’s something out there: the debris of a story yet to be articulated.

To overlook the past constitutes a huge affront, whether it’s because you live in denial, or because your loved ones who took care of you as a child did. I’ve heard a lot people saying: “What is past, is past. Don’t look behind. Just stick to the present”. Still, when you are intersex, ignoring the story of your birth carry a lot of consequences and events in your life that develop into issues that, all of a sudden, become untraceable, because no one can remember when it started. You find yourself unable to rebuild a narrative and you really can’t talk to no one, for the ones who were supposed to know best are no longer there. Where are now the surgeons who cut you open, who took your gonads away, who shaped your body for society’s own satisfaction? Dead. Retired. Anonymous. Your files? Gone too. Disposed several years ago, because nobody claimed them. Your parents? They’d rather not to go back, it’s hurtful. Of course it is; back then there was so much fear, so much confusion, so they went by the “experts’” suggestion, and kept it to themselves. They kept quiet, hoping time, silence, and an overprotective upbringing lasted long enough so you wouldn’t need to look back. Until you were fully grown and self-sufficient.

But one day, it all falls into place. Then you realize: they’ve lied you all time. No matter how well intended it was, it hurts.

A broken story I say, because no one would speak of it. I was thirty when I finally got it. Not that I was clueless; as I was growing up, and out of necessity, my mother had to drop some answers to what were tangential questions. Unconsciously I was frightened too, I believed there was something crooked about me, because the memories of home and hospital I had left me that impression. In my thirtieth anniversary on this Earth, all the memories, the scars, the psychotherapy, the loose bits of information from my mom and the avalanche of data collected through years of suspicion and deduction gave form to a more or less articulated narrative. For a lack of a clinical file, my parents’ memory finally came through for me, and the story started to take shape.

Once upon a time, I was born, the youngest of three siblings. My sisters were excited about my arrival. Everything marched on as one would expect in a household with a newborn baby. But one day, after only one week of life, my mom concluded that she shouldn’t disregard what she had already noticed: that my body was different. My mom didn’t really know if it was something to worry, but it didn’t seem right as far a she knew. Should a little baby girl have a clitoris that big? A multidisciplinary team of physicians gathered. Oh what an occasion it was for them. They diagnosed me with “true hermaphroditism”, 47 XXY. They informed my parents they had to remove my ovotestes because of “the latency of cancer”. Also due to my “genital ambiguity”, they talked about viability as a girl or a boy, but they emphasized that it was better (easier, they meant) to feminize my body. After all, my parents had already two girls, so I would fit better. And so it was decided; my parents hoped for the best, and even since I was just six months old until I was eleven I underwent three different surgeries. One of my earliest memories comes from the second surgery: I was lying on a bed in a common room of a renowned public hospital of in Mexico City. The paediatric urology wing was on a floor in the middle of the building, because I remember the tawny light of the street lamp sneaking in through the long window, opposed to the dim white light of the halogen lamp from the corridor just outside. I was four, and I had a cast of some sort with the shape of a diaper, around my waist and covering my pelvis. I still can feel it’s rigidity and the fear I had of moving my body at all… More lucid is the memory of the third surgery. I just had turned eleven two weeks before. Although I was no defenceless creature, I meekly entered the hospital that time, and I was submitted to a vaginoplasty which I had only the faintest idea what would do for me. Mom had told me it was “to fix” my genitals so I didn’t have problems when I was older. I didn’t get what kind of issues those might be. I guess she thought unnecessary to explain what the vagina was (actually I mixed the notion of vagina with that of the urethra then and a after for a while), and what was the use everyone expected for it. I remember the months before that, the doctor who attended me inspected my genitals, and the week before, I think, they draw blood samples for the analysis prior to surgery. All those moments are like snapshots today, but snapshots that come with the memory of my skin hurting down there, the fingers covered by latex poking my urethra and my incipient vulva. It was my body he was touching, and I was uncomfortable, ashamed. But I endured it because if my mom had taken me there, so the fact of me being at hospital could only mean that it was all in my benefit, and if I had been going to those revisions and sample-takings, it was because something was wrong with me. Bottom line that was the problem: my body. So when the surgery finished and I was sent to my bed, one of the doctors artlessly said to my dad: “your daughter is ready for life”. To this day, I still don’t have a fucking idea of what life he had in mind. Certainly not the one I ended up living years later… A lot of white coats came to see, the residents along with the physician in charge, lifting my sheet on the lower end to inspect, to show and explain the young doctors what were they looking at. I was appalled, but again, I thought I should be okay, if my mom was allowing it, the physician was showing something that was fine now. Or was it? Because I still had to go to the clinic to the follow-ups, in those crowded third-worldly, khaki-walled cabinets (and this I’m talking about was one of the best public health facilities in Mexico), having to exhibit my body to this new doctor in charge of my case. At age thirteen he started asking if I had a boyfriend already. I’ve always been shy (a characteristic of the upbringing I had, I guess), and frankly boys weren’t of much interest to me. The question troubled me. A part of me wanted to reply: “No, and it’s not your business anyways!”. But my mother was there, and I politely said: “No, I don’t”. Now I know it wasn’t just chit-chat, and that he was aiming at something when asking those sort of things.

At that same age I started hormonal replacement therapy. I had to take one elliptic, burgundy pill a day: conjugated equine estrogens (CEE). I didn’t quite understand why I needed “extra” hormones (I wasn’t aware that I had no gonads anymore). I asked what was that pill for. My mom, the only possible source of answers at home, told me it was for my body development. I was embarrassed to keep asking. When it came to talk about my body, I was twice as embarrassed, because I wasn’t comfortable with the whole concept of adolescence for starters. I was fine with the idea of my body getting taller. I was nuts for sports since forever, and I loved basketball. But my mom would have me behave more feminine. I guess I’ve always had a feminine look, or androgynous at the very least, so I suppose she thought I would perfectly fit if I just used a bit of make-up and wore dresses and skirts and girly shoes. I did that, when I was a kid, and only a number of times. But as a teenager I most certainly didn’t, unless she urged me to do so. Again, now I understand why she felt the need to behave like that. On the other hand, I was embarrassed too because of the deep-rooted notion that there was still something wrong with my body, even if I hadn’t the language to name it, and that it was a source of shame and concern so we had to keep it secret. In this way, unconsciously, quietly, I was the family secret.

The fact that I never had any boyfriend nor girlfriend helped me to avert any confrontation about myself. However, at university I started to wonder why I didn’t menstruate. I knew that some girls would begin as late as twenty-one. It was like a clock ticking to me, and I couldn’t figure out why the period hadn’t come. A part of me was relieved, because I didn’t want to experience the nuisance I knew other women suffered, but it was the very idea of something wrong going on about my body that began to flow in my thoughts.

Also there was the part of the unfulfilled sexual desire; whenever I wanted to please myself, pleasure was brief and unsatisfactory. When I wanted to find what was supposed to be “the female organ of sexual pleasure” with my fingers, I only found discomfort and discontent, because wherever I touched I could barely feel anything pleasant beyond the mere pressure of my fingertips. The funny thing is that I felt how my body was aroused, but when I tried to keep it on, it just stopped. Later I figured some other ways to please my body, but since long I’ve come to terms with the fact that my genitals aren’t able to provide me with pleasant sensations. And when my mother, years later, finally confided me how my body was born and I joined the dots about the procedures I underwent, I knew for sure the sensitivity of my genitals had been affected during one of the surgeries. Of course, that’s not something my parents would know at that time.

There’s a consequence of growing up with the idea of your body being wrong and the unnamed and unfulfilled need of reassurance that you’re okay that I think is as damaging as surgeries: a low self-esteem. I grew up looking always for my parents’ (and every authority figure’s) approval on everything. For long periods of my life, my self-esteem was acceptable because I tried very hard to make up for the things that I knew or I felt I wasn’t good enough. I became a student of excellence, not just because I loved to learn, but also because I believed it was the only thing that would keep my parents from feeling disappointed of me. I thought I was worth no more than that. Thus, the day I announced I’d decided to major in History, which should have been a happy one, turn out to be depressive. I knew I wouldn’t be able to find a “historian required” job advertisement in the newspaper. What got me was the rejection feeling I had that day when every member of my family gave me a piece of their minds. I wanted to please them so much that I picked the “easy” choice, and ended majoring in Computer Engineering, just because I would easily find a well paid employment and be self-sufficient. Sure, computers and programming were easy to me, but I didn’t love it.

Funny thing: even when you try to conceal your own self, it eventually blooms. Even if you have played the teacher’s pet role and the good girl too, because it’s the only way you got to behave in order to survive, the true call shows up. I began to write. I always had loved the readings of myths, fables, tales, novels. Ever since junior high I essayed to write my own stories. But it was only at university that I acknowledged how badly I needed it. However, when for mischance I mentioned my parents I’d like to dedicate my life to it, my dad lectured me about it. I remember how I cried that day, and from that day on I almost stopped writing. I muted my inner voice. Then my body started to complain. My health, which had been great since forever, started to decline. I got hepatitis A. I sprained my right ankle three times in five years, even when I hadn’t done any more sports nor exercises. That too: I abandoned sports, which was something I loved, because I sensed my mother disliked (although tolerated) the fact that I played football (something I did with fruition when I was a teenager and later on at university), probably because it wasn’t seen as a feminine activity in Mexican culture. My cholesterol and triglycerides levels raised above the norm, not because I was overweight, but because of the continued state of stress at work. Anxiety had been a constant in my life, so I thought it was ordinary too at work. I guess I knew I hated my career as software developer almost since it started.  I was angry all day, I ranted about almost anything. I fell in love with a woman who loved me back but just as a friend, and in that regard I grew bitter. I went to three different psychotherapists, and while at first things would get smooth, and I felt optimistic about my future and made plans, it wouldn’t last.

And then I turned thirty, as mentioned before, and my life started to crumble, one year at a time, until at thirty-three things got out of control. No psychotherapist could help me to cope with the findings of my own story, and I turned against my parents. I started to inflict me physical damage and became deeply depressed. While I didn’t love it, I had been a reliable employee at every job I had; but when the very work assignments became impossible to accomplish and the pressure was unbearable, this is, when I became to hate not only that specific job but my career pick, I started to skip work and stay at bed all day, crying and cursing everything and everyone. I thought I had reached my lowest. So I quit. Then a week later a friend offered me a job of the same kind. I thought it would be different, as it was a different company and a better work environment. But the day before I’d started, I snapped. I cried like I had never cried before in my life. I kept saying out loud: “I can’t do this. Not anymore. Not anymore.” So my mother helped me to reach my friend and excuse me, that I wouldn’t be able to show up the next day, and that I would contact him. My friend understood.

So began the hardest year of my life: the year to learn to forgive, the year to learn to love myself, the year to learn who I really was and what I really wanted to do, the only thing I had never sat down to think thoroughly. And furthermore, the year to embrace my body as it was, not as it could’ve been. Interestingly, I started to menstruate due to a change in the hormonal replacement therapy, because the CEE had caused me a myoma in my uterus and I had a constant haemorrhage. The gynaecologist prescribed me contraceptive patches, and the haemorrhage ceased. The myoma also reduced it’s size. However, he warned me that from then on I would menstruate, because I took the CEE everyday, but the patches followed a menstrual cycle. So it happened. At first that angered me even more. Now that I had gotten used not to menstruate, the period came punctually every month! But as I came to terms with my body, I took it as a sign of me changing. Now I’m fine about it.

One of the things that troubled me during the time that I learned to deal with me being intersex was to accept myself as a woman in all aspects. I was really confused when I discovered the fact that I could’ve been raised as a boy, because as a kid, apart from the dresses and all that stuff, I always had the need to play along with the other boys, and once I even got in a fight with one. I played football at streets with my neighbours, all of them boys. My sneakers and I were one, I never was interested in heels and that sort of things. I liked boys (I actually had some crushes for some of my male friends), but I liked girls too, as early as kindergarten. Just when I got my first boyfriend at university I considered the idea of being more “feminine”, but I couldn’t just be like that. That relationship just faded as I distanced from him, because we wanted to have sex but I wasn’t sure that my body was okay when I compared the reflection of my vulva and vagina in the mirror with the pictures I search online. Then I thought only a woman would take me. And a year later I fell deeply in love with a friend, a girlfriend, who loved me back but not in a romantic way, but as a sister, as a confident, indeed as a best friend. Considered all these things, when I found the circumstances of my birth all I could think was that life, not just mine but life itself sucked. For a while I pondered the idea of transition my body, but I wasn’t sure, because I was so sick of surgeries, and I questioned myself: do you really think you’re a man? When the answer emerged smoothly, I discarded the idea. Later on, when I started to gather information about intersex, I wondered if I it could be that I was non-binary, or gender-fluid. But I understood as I let it marinate that this conception of my own gender wasn’t just something I could say like “hey, I like green”, but it should reflect a profound sense of oneself, of how one projects one’s own identity. It’s funny how long can be the path to become a woman. I’d been taken for granted a woman all my life; but it’s just since a while ago that I came to consider myself a woman. An intersex woman. And I’m in the path of learning how to embrace it, and enjoy it, and live it with fulfillment.

I’m not saying that being intersex it’s the cause of all my wrong decisions. But society played its part. My parents’ fears, the physicians’ authority, played a decisive part in the shaping of a psyche with a low self-esteem and a need for acceptance. This was society’s prejudices work. It’s not being intersex but the regard of society about it, the stigma, their notions on how should be a girl or a boy both in their body traits and their gender identity. I can see now a pattern among the stories of many intersex adults whose physical and mental health were undermined since their early years because their bodies posed a threat to the mind constructions of people around them. Kids, all kids, are very sensitive. They sense their parents fears easier than we think. And intersex kids sense fear, rejection, guilt, shame. Not all of them, fortunately. Some had the luck to have knowledgeable, brave parents who said “No” and instead chose to healthily discover a different world through their intersex children. Those are the experiences we need to replicate in this world in order to stop unnecessary suffering. Life itself is complicated. We have no need for further problems. And most certainly, surgeries and therapies haven’t proved to be any sort of solution. Maybe a brief relieve for stressed parents, who didn’t know they had a choice. Them, parents, need also our support. They have to learn that they’re not alone, and that there’s no rush.

We need no more broken stories. Intersex people should have a right even since they’re newborns to develop a life of their own, to explore what the world has for them, to bloom and discover who they are and who they want to be, and be the ones to call the shots about their own bodies. Well, that should be true for all people as a matter of fact. And as any other person, intersex persons should never have to live a broken story, cut and edited here and there, just to be liked.

As of today, I keep writing a new story for me. To make it of my own. To forgive where there was love, and to forget where there was ignorance and negligence. I don’t care for grudges. I rather want justice. Maybe not for me, but for others. I also want to help others if they ask me a hand.

As a conclusion, there’s something I’d like to ask from parents of intersex children in Mexico and worldwide: Seek for help!! Get informed, ask for advice, not just from one physician. Even if slowly, there’s a shift in the way some sympathetic doctors regard intersex. There’s nothing intrinsically unhealthy about having different sex characteristics from the usual notion of male and female. But learn about your children health needs, because each person is different. There are medical conditions not to be ignored that may be associated to a specific intersex variant. Approach intersex activist organizations, such as Brújula Intersexual or Intersex Day. They’ll be willing to offer their experience and counselling. Get rid of fears and doubts. Ask everything you need to ask. Just don’t stick to a “disorder of sex development” diagnosis, because that will work against your children best interest. Embrace your babies as they are. If needed, assign a gender, but don’t go for surgeries. You have in your arms little human beings with the potential of becoming full-grown, happy, fulfilled persons.

 

My life as an intersex person: 7 sisters, 7 brothers… and I. By Mar IS

My life as an intersex person: 7 sisters, 7 brothers… and I

By Mar IS

EN ESPAÑOL

*This story was shared by Mar IS for publishing in exclusive by Brújula Intersexual. If you want to republish it anywhere else, please request for the author’s permission addressing to intersexualmexico@gmail.com.

Originally published in Spanish: https://brujulaintersexual.wordpress.com/2016/06/28/mi-vida-como-intersexual-7-hermanas-7-hermanos-y-yo-por-mar-is/

Translated by Laura Inter. Edited by Hana Aoi.

MarIS

I was born in Mexico more than 30 years ago. I was born with an intersex body. I didn’t know it. When I was born everything was “normal”, apparently there was nothing unusual in my body. I was assigned as a girl, but ever since an early age people made me feel different.

I became aware of changes during puberty. My body developed quickly, it started to grow more body hair than usual, especially in my legs and arms. When I was 12 years old, I stopped growing up. My body was strong and beautiful, I was stronger than other girls and I liked how my body looked like.

My body already had by then an androgynous look: my shoulders are broad, I have almost no hips, my arms and hands are stronger than usual, I barely have breasts and as I mentioned, I have a lot of body hair; I even got a beard. However, my voice is rather feminine and so are some of my physical traits. Although I no longer identify myself as a man or as a woman, it’s because I was assigned as a female at birth that I’ve gotten used to refer to myself with feminine pronouns. People have always felt confused about my gender because of my appearance, sometimes they think I am woman, sometimes they think I’m a man. I’ve always had problems for it. It’s common that people kick me out of the ladies’ bathroom, or tell me I’m in the wrong one. No matter how I dress, other people are usually confused about my gender

I was born in a remote community, a very small town, where everyone knows each other. So it was impossible for me to go unnoticed. Since childhood I began to be bullied by my own family and people around me out of prejudices about my body and my behaviour (that was considered as male) In my family I was abused in many ways: lack of care, lack of clothing and shoes, and even lack of food. My mother worked all the time, always had problems and had no time for her children. My father was always drunk, unable to spend a little of his time with us. Because of this lack of attention, when I was very small, I suffered from sexual harassment and sexual abuse by three different persons much older than me. Sometimes I thought that it had been only bad dreams, but it had been all real. Today I still struggle to overcome this horrible trauma. I still get nightmares because of that.

When I was in elementary school, I began to be bullied because of my physical features by my classmates and even by some teachers. At that time, I didn’t understand why I was bullied. I only knew there was rejection in their body language and their words. All of this really bothered me, but I tried not to give it too much importance.

When I was 12 years old, I had my first boyfriend. My family didn’t like him, because he was older than me, so every time I was with him, my mom instructed one of my brothers to bring me home and hit me. At 14, I had another boyfriend. The first three months seemed that everything was fine between us, but later he began to tell me things like: “You look like a man”, “When I kiss you, I feel like I’m kissing a man”, “Your breasts are very small”, and so on. For these and other comments, I went to see a doctor. She asked me to take off my shirt, then she saw and touched my breasts, and also reviewed my genitals. She said to me: “There’s still chance to do something”. After the medical examination, she asked me if I’d be willing to remove my clothes and be examined by other doctors, in order to get help. Shyly I replied, “Yes”. Outside the doctor’s office there were people who knew me, and I realised that they had heard everything spoken inside the office, so I was concerned about it. A few days after, a cousin told me that she had heard rumours that I was actually a “man”. When I heard this, I became really angry. Because of this and the lack of money, I didn’t want to return to the doctor, and I tried to forget it all.

At school I had to wear a skirt. This was a constant nightmare because of the abundant hair on my legs, so I had to shave them constantly. One time I didn’t shave them well, and one of my classmates noticed. Gossip spread quickly all around the school and everyone started to bully me. They saw me as a “weirdo” and made hurtful comments. I felt very embarrassed, it was a very ugly experience and my self-esteem suffered. Furthermore, a beard began to grow on my face. I couldn´t hide my differences so easily anymore, I suffered deeply in silence. Who could I talk about the things that were happening to me? I was frightened and felt a lot of shame.

I had a friend from childhood, we used to spend a lot of time together. She seemed interesting, nice, pretty. My mom, however, didn’t like her and often prevented me of being and spending that much time with her. And then people started to say that we were lesbians. We didn’t care, we just laughed at the gossips.

Our friendship ended the same day of her wedding. Something happened: I saw her brother-in-law taking her to a room to talk. When he came out, he looked at me with a disdainful look that really scared me, then he started talking to his friends and I noticed that everyone turned to look at me, they looked at me with morbidity and mockery. That day I went home bewildered. I thought everything would be fine, but it wouldn’t. As days passed, this became something bigger, now the whole community, men, women and even children, one of my brothers too, everyone saw me with an accusing look. I just couldn’t summon the courage to ask what was going on. It was something horrible, I couldn’t even defend myself because I didn’t know what caused it. I confronted my friend, tried to talk to her and understand what was happening. She denied everything. There was no one I could talk to, nobody I could ask what was going on. No one had the decency of telling me what the community was saying about me, everything was fuzzy. I wanted to die, I wasn’t able to sleep. It was a nightmare for two months.

As days went on, I felt worse. And I was completely alone.

At 18, I started to gain weight, I felt depressed, anxious, I slept a lot. I spent nearly two years doing almost nothing. Due to my weight, my brothers began to mock me.

When I was 20, I moved to another town, along with my parents and a sister, because my dad got ill. After a year, my parents returned to live in the community. But my sister and I decided to stay. She went to high school and I began to study and work. We spent two years like this, and in this period of time I felt very good and found peace. I managed to finish high school. I wondered what else had the life for me.

In that little town, I freed myself from the pressure of both family and community. I began to discover myself. I underwent psychotherapy, where I faced something I only wanted to deny: the sexual abuse I suffered as a child. For the first time in my life I talked about it. It was something terrible, I became depressed at confronting the truth.

Later on, my sister and I decided to enter university. This was another change. Another of my sisters decided to join us and went to live with us. They had always been very close and, when for some reason we discussed, often they agreed on whatever subject was at discussion, and always turn against me. I felt alone again.

Many things were new to me, life in the city was very different from the community, most of young people were “extroverted”, I felt out of place in many ways and situations. I felt I was ignorant. However, there was I: trying, maybe with no direction and unsecure, but trying nonetheless. Even with all the difficulties, I knew that university was an opportunity that never crossed my mind I would take. With all my limitations, my difficulty with communication and economic hardships, I kept going.

It was very difficult for me to expose in front of the class. Speaking in public was tough. When I knew I had to deliver a presentation, days before I felt anxious and fearful. I rarely spoke in class. I met and talked only to a few girls who were introverted like me. However, as they passed the time badmouthing about others, I didn’t found them trustworthy. I still felt alone for long periods. I barely spent time with my sisters.

At that time, to calm the anxiety and loneliness I felt, I started to watch pornography and I began masturbating frequently. I felt this “helped” me to escape from reality for a moment. But after a while, I felt shame and guilt, I also felt that this was hurting my body and spirit. This became a vicious circle that seemed endless.

I started taking swimming lessons. Since the beginning of the lessons the instructor saw me differently from the other girls in the lessons, I felt his disdainful look, this bothered me a lot, and I was sure that he looked at me like this because of my body being different. So I wore a complete swimming suit, tried to ignore him and concentrated on the lessons. I learned to swim, and it helped me to raise my self-esteem and improved my health.

During university I went through a lot of stress, I also neglected my appearance. I was able to travel; those were happy moments in my life. My favourite trip was when I travelled to the coast and saw the sea for the first time, it was an amazing experience.

After finishing university, I met a man. I liked him. We had a couple of dates, but because of my insecurities and low self-esteem, he ended staying away from me. One day we had a date, but he never arrived.

I still felt alone. I really wanted to have a partner and receive affection and love, so one day I decided to go out on a “blind date” with a friend of my sister’s boyfriend. So the four of us met and went to a bar. That night I drank too much alcohol, until I lost consciousness, I just remembered a few things when I woke up. The next day, I was aware of what had happened to me, this man abused sexually of me while I was unconscious. I felt horrible, I sought psychological help and I could quickly overcome this experience.

It came the time to do my professional practices. With my fears and insecurities, I travelled to another city and state, to work at a tourist park. There I was very well treated. I met a young woman from Mexico City, she was an outgoing and friendly person, and she caught my attention immediately, we began to hang out, because we lived together in the same house. She listened to me and treated me kindly. I was attracted to her, and although she had a partner (her partner lived in another city), we began a relationship with no commitments. She treated me fine, she “accepted” me as I was and moreover I finally found someone who didn´t criticize me or my body, so she quickly became special. As time went by, the relationship predictably began to fail. I believed that in the time we spent together, I had lived both the “happiest and unhappiest” moments of my life. It was with her that I had intimacy with someone for the first time. During sex, I realised that my genitals were different from hers. My clitoris was much bigger than average. That made me feel insecure, but she “accepted” me as I was. So at first my self-esteem increased, but then it crashed down. Apart from her having a partner, she was promiscuous, and I began to be jealous about her behaviour. The relationship became somewhat sickish, but I stayed because she was the first person who treated me as someone “normal”. So, after three months I ended the relationship and stepped away from her. I felt stronger and weaker than ever. After all this years, for the first time I had felt alive and “normal”, but my emotions were out of control. I felt that I loved her, but I also felt I hated her. There was so much confusion and pain.

One day, tired of my appearance, tired of not being “woman enough” or “man enough”, tired of always being trying to be something I was not, I cut my hair. At that time, I had it very long, so I decided to cut it very short. I did it on an impulse. In doing so, something changed: I looked younger and I looked better with short hair, I was more relaxed, even I started to accept that I liked women, though I didn´t completely identified myself as a lesbian. Even now, I don’t feel like a lesbian, because never my appearance nor my gender identity have been a 100% female or male. At that moment, I tried to reaffirm my sexual preference for women but, because of the education I received in my family (one heavily influenced by the Catholic religion), sometimes I felt dirty and perverted, but that feeling disappeared over time.

With this change in my look, I gained confidence. Some girls started to approach me, but I was unsure about starting over a relationship. I was still hurt about the last relationship. Somehow I closed myself to the possibility of any relationship, so I focused in work. Then I started to get sick. I was tired all the time, my body and my head ached.

After a while, I resolved to major in something else, but my economy wasn’t the best and my health got worse. University was already causing me a lot of stress, so I dropped out.

I decided to work in a different state, and so I moved. I worked for a while in a tourist park, only during the high season, when there were many visitors. But eventually I moved back again with my sisters.

I became deeply depressed for about four months. The sense of loneliness was greater, I had no money and, to make it worst, I still felt sick. Although I had consulted many doctors and I received different diagnostics, the prescriptions I got didn’t work. The worse came when doctors ended up asking me inappropriate things because of their prejudices about my appearance, such as: “What is your sexual preference?”, “When will you decide on your gender?” “Why you don’t take female hormones or go to an endocrinologist?”. As a result of these situations, all I wanted was to DIE!

To distract myself and try to resume my life, I began to volunteer on issues related to ecology, and also got a job, so for a while, even though not everything was fine in my life, I felt a relative stability.

At that time, I started dating a girl I liked and we had a great time together. However, she often didn’t arrive to our dates and stood me up, so this depressed me again and increased the feeling of loneliness, which had been a constant during most of my life.

I decided to move again and I got a job in the same tourist park where I had worked before. I still didn’t feel my health was the best, but I needed to keep busy. I started working by mid-2015, and while it was a job already familiar to me, it still caused me a lot of anxiety and fear, possibly due to discrimination and bullying which often I am an object because of my androgynous appearance. This has happened every time I start a job, studies or, in general, something new. Unfortunately, the extremely hot climate of that place and the anxiety and depression I was suffering worsened my health. I felt tired all day long, and often had fever.

In the park I met new people. Again, it became a source of anxiety and insecurity, because it is common that people inquire me about my physical differences. And they did. But I realised that sometimes it is mere curiosity, and comments made by them weren’t always malicious. Plus, the park is located in a tourist place where people in general are open to diversity, so I made very good friends there.

I blamed the stress of “being different” for my poor health, for me being depressed, for the anxiety, for the insecurity, for everything. Again, I felt I couldn’t take it anymore. I couldn’t sleep for a long while, I suffered a lot both physically and emotionally, I no longer wanted to live.

I remember that once I had read something about intersex, and suspected I was an intersex person, I was almost completely sure. One day, searching on the internet, I found the web page of Brújula Intersexual, so I began to read the stories of other intersex people. This reassured me, because I didn’t feel alone anymore. I saw myself reflected in many of the intersex people who shared their stories, but still didn’t know someone like me.

My wish was to meet another person like me. As I read all the medical abuses and social problems faced by intersex people, I had also the intention to become an activist, even if it turned out that I wasn’t intersex.

In my despair, one day I sent a message to the Facebook page of Brújula Intersexual. I sent it without any hope of response, but to my surprise, the administrator of the page answered me back, and gave me information and support. She shared with me part of her own story. I started talking on the phone with her, I told her about my experiences, and about my different body and its peculiarities. I told her about a medical exam I had performed long ago, in which my testosterone levels were very high. I also told her about my genitals differences, and so. She told me that I was an intersex person and that there was nothing wrong with me. I was happy to confirm that I was intersex, but also a part of me felt sad because I still wanted to be “normal”. Even now, it’s a little hard for me to acknowledge that I’m intersex, as my physical differences have brought me nothing but problems and discrimination in my life.

Now that I’ve met more intersex people, I no longer feel alone. I’ve finally found people who get me. I don’t have to explain anymore about myself, we just share our anecdotes, traumas, stories, and so on.

This is the first part of my story, I’ll write the second part soon, about how my life took a complete turnaround since I met others like me, because now I share my life with a partner who loves me, respects me, and is intersex like me.