美国国家公共电台 NPR--Where gender-affirming care for youth is banned, intersex surgery may be allowed

Where gender¹-affirming care for youth is banned, intersex surgery may be allowed

Transcript²

Multiple U.S. states have banned gender-affirming care for transgender people under the age of 18 this year alone. Indiana and Idaho are the latest to do so.

But in some states, "gender-normalizing surgeries" are allowed on intersex infants with "ambiguous sex characteristics." (That's the case in Georgia, Kentucky, and South Carolina.)

Those "ambiguous" characteristics apply to an estimated 1.7% of the world's population who are born intersex.

External characteristics of intersex may include underdeveloped genitals, which is a symptom of partial androgen insensitivity syndrome³.

What Does It Mean To Be Intersex?

Sean Saifa Wall knows intimately the impact of this syndrome, and of the surgery he says he did not approve. Wall was 13 years old when doctors alerted his mother that his undescended testicles were cancerous. His mother opted⁴ to have them removed. But he did not have cancer.

"I received my medical record at 25. They were not cancerous," he told NPR's Leila Fadel in an interview.

Even in 2013, the United Nations called for an end to "genital-normalizing" surgeries like the one performed on Wall. Six years later, the organization continues to condemn⁵ operations on intersex youth, calling them "coercive" and "medically unnecessary."

Wall says of his operation: "Essentially⁶, I referred to it as a castration... I wish that someone would have asked me what I wanted to do. I wish someone would have explained to me in the language that I can understand at the time of being a 13-year-old child. This is what's happening with your body."

The language he uses to condemn coercive "gender-normalizing" surgeries and the "talking points of the intersex movement," Wall says, have been used against young people who are transgender.

"This is so bizarre, right?" Wall said. "You have these trans young people who are very confident in who they are ... and they're being actively⁷ denied affirming health care. Whereas intersex children do not get to consent about the surgeries that they have."

The Societies for Pediatric Urology's most updated stance on the topic does not advocate for a ban on all surgery on intersex children: "A moratorium⁸ on all surgery would be as harmful as recommending surgery for all," it says.

Sean Saifa Wall spoke⁹ to NPR's Leila Fadel about how laws banning gender-affirming care for transgender youth have impacted young people with intersex characteristics.

This interview has been lightly edited for length and clarity.

A lot of the language that's in the bills that de-transitioners are using: saying that they were mutilated, saying that these were medically unnecessary. I'm just like – medically unnecessary surgeries are actually happening to intersex young people. ... That's very compelling language that conservatives are actually using to describe ... these gender affirming procedures that trans young people are getting. And that's just not true.

On the difference between transgender and intersex individuals

I think the biggest difference is consent. They're trans young people who are like, "these experiences during puberty are making me feel uncomfortable, and I want to be able to stop that." Intersex young people don't get to make those decisions about their bodies. It's more so, we're told that these procedures need to be done for our wellness. But what is underlying¹⁰ that, is that we're actually abnormal, that we actually need to be fixed¹¹ to be normal. And those are just lies, and it's paranoia¹².

On regulating care for transgender and intersex children

Every case is very unique, and I think what's happening now is that there is a broad stroke applied¹³ to all people with intersex variations. I do feel like there should be ... a case by case basis as opposed to just doctors being the arbiters¹⁴ of a person's gender identity — a person's body. I think doctors should ... be accountable for why these procedures are being done.

What's often happening is that parents are seeing surgeons before they're actually getting psychological support, affirming health care for intersex children as actually being compassionate¹⁵, and actually treating each case differently. And that is not what's happening.

1 gender   

n.（生理上的）性，（名词、代词等的）性

参考例句：

• French differs from English in having gender for all nouns.法语不同于英语，所有的名词都有性。
• Women are sometimes denied opportunities solely because of their gender.妇女有时仅仅因为性别而无法获得种种机会。

2 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

3 syndrome   

n.综合病症；并存特性

参考例句：

• The Institute says that an unidentified virus is to blame for the syndrome. 该研究所表示,引起这种综合症的是一种尚未确认的病毒。
• Results indicated that 11 fetuses had Down syndrome. 结果表明有11个胎儿患有唐氏综合征。

4 opted   

v.选择，挑选( opt的过去式和过去分词 )

参考例句：

• She was co-opted onto the board. 她获增选为董事会成员。
• After graduating she opted for a career in music. 毕业后她选择了从事音乐工作。

5 condemn   

vt.谴责，指责；宣判(罪犯)，判刑

参考例句：

• Some praise him,whereas others condemn him.有些人赞扬他，而有些人谴责他。
• We mustn't condemn him on mere suppositions.我们不可全凭臆测来指责他。

6 essentially   

adv.本质上，实质上，基本上

参考例句：

• Really great men are essentially modest.真正的伟人大都很谦虚。
• She is an essentially selfish person.她本质上是个自私自利的人。

7 actively   

adv.积极地，勤奋地

参考例句：

• During this period all the students were actively participating.在这节课中所有的学生都积极参加。
• We are actively intervening to settle a quarrel.我们正在积极调解争执。

8 moratorium   

n.(行动、活动的)暂停(期)，延期偿付

参考例句：

• The government has called for a moratorium on weapons testing.政府已要求暂停武器试验。
• We recommended a moratorium on two particular kinds of experiments.我们建议暂禁两种特殊的实验。

9 spoke   

n.（车轮的）辐条；轮辐；破坏某人的计划；阻挠某人的行动 v.讲，谈（speak的过去式）；说；演说；从某种观点来说

参考例句：

• They sourced the spoke nuts from our company.他们的轮辐螺帽是从我们公司获得的。
• The spokes of a wheel are the bars that connect the outer ring to the centre.辐条是轮子上连接外圈与中心的条棒。

10 underlying   

adj.在下面的，含蓄的，潜在的

参考例句：

• The underlying theme of the novel is very serious.小说隐含的主题是十分严肃的。
• This word has its underlying meaning.这个单词有它潜在的含义。

11 fixed   

adj.固定的，不变的，准备好的；(计算机)固定的

参考例句：

• Have you two fixed on a date for the wedding yet?你们俩选定婚期了吗？
• Once the aim is fixed,we should not change it arbitrarily.目标一旦确定，我们就不应该随意改变。

12 paranoia   

n.妄想狂，偏执狂；多疑症

参考例句：

• Her passion for cleanliness borders on paranoia.她的洁癖近乎偏执。
• The push for reform is also motivated by political paranoia.竞选的改革运动也受到政治偏执狂症的推动。

13 applied   

adj.应用的；v.应用，适用

参考例句：

• She plans to take a course in applied linguistics.她打算学习应用语言学课程。
• This cream is best applied to the face at night.这种乳霜最好晚上擦脸用。

14 arbiters   

仲裁人，裁决者( arbiter的名词复数 )

参考例句：

• In the forensicfield, the final arbiters of quality are the courts. 在法医学领域，质量的最后仲裁者是法庭。
• They are, increasingly, arbiters of which types of borrowers get credit. 它们正越来越多地充当决定哪几种借款人可获得信贷的裁决人角色。

15 compassionate   

adj.有同情心的，表示同情的

参考例句：

• She is a compassionate person.她是一个有同情心的人。
• The compassionate judge gave the young offender a light sentence.慈悲的法官从轻判处了那个年轻罪犯。