Adult Genital Surgeries for Intersex Present Problems

A recent article entitled “Adult Genital Surgery for Intersex: A Solution to What Problem?” by Mary E. Boyle, Susan Smith, and Lih-mei Liao suggests that genital surgeries among adult women with intersex conditions present dilemmas similar to those involved with infant surgeries.

After conducting interviews with six adult women who chose to undergo genital surgeries as adults, the authors concluded that the women in their study often experienced little or no dilemmas surrounding the choice to have surgery but that the women felt conflicted after surgery. Prior to surgery, the women in the study believed that having surgery would “confer normality” and help them feel they were entitled to intimate relationships. The interviews also revealed that the physicians caring for the women in the study often presented surgery as unproblematic course of action and that for some of the women challenging medical authority—even as adults—was very difficult.

Although the women imagined the surgeries would alleviate problems with sexual intercourse and intimate relationships and improve their self-perception, the authors report that the women in their study faced several dilemmas post-surgery. First, the authors report that the surgeries didn’t produce the results the women expected. For example, some of the women were surprised by the post-operative pain they experienced. While their physicians informed them that pain would be involved, a few of the women noted a marked discrepancy between the way their healthcare providers described what the pain would be like and the severity of the pain they experienced.

The second post-surgery dilemma the women experienced was the realization “that post-operative procedures would be a continual reminder of difference.” While several of the women thought “normalizing” surgeries would be the end of the process, many of the women reported that dilation was painful, their sexual pleasure was not increased, and that having surgically altered genitals didn’t remove the need for conversations about intimacy with their potential partners. Additionally, one of the women stated that the regular trips to the doctor’s office necessitated by the surgery served as a constant reminder that she was “different.”

The authors of this study suggest that adult intersex surgeries present similar problems as childhood genital surgeries in the sense that these surgeries are often about “normalizing” the appearance of the genitals and creating genitals capable of certain kinds of sex (heterosexual penetrative sex, for example) rather than the ability to experience sexual pleasure. From these interviews, the authors conclude that outcome studies and conversations about adult genital surgeries for intersex conditions are lacking and that more critical attention is needed. The authors note that although adult surgeries are often considered unproblematic because they are consensual that there might be other salient issues to consider.

Full citation for the article:
Boyle, Marie E., Susan Smith, and Lih-mei Liao. “Adult Intersex Surgery: A Solution to What Problem?” Journal of Health Psychology (2005): 573-584.