Intersexuality refers to a variety of forms of ambiguous gender identity. It occurs when the external and internal physical sex characteristics and the genetic characteristics of a person do not coincide. Intersexuality is a topic that is still a taboo in public. Yet the topic relates to fundamental questions of medicine and ethics, of the fundamental rights of those affected and of our understanding of sexuality.
For the German Ethics Council, the topic of intersexuality is the occasion to create the first online discussion platform for the subject. With immediate effect, the debate on intersexuality can be continued in public at http://diskurs.ethikrat.org (in German).
In the two forums on the topics "Medical treatment, indication, consent" and "Quality of life, social situation and prospects of intersex persons", experts and persons affected presented their positions on the topic. This was followed by questions from the members of the German Ethics Council. Finally, questions were collected from the audience and passed in batches to the experts.
The experts included doctors, psychologists, lawyers, representatives of parents' initiatives, associations and organizations of those affected. The purpose of the hearing and of the public discourse following the hearing (until 31 July 2011) on http://diskurs.ethikrat.org/ is to prepare an Opinion of the Ethics Council on the subject of intersexuality for the Federal Government by the end of 2011.
The following questions were particularly controversial: May intersex newborns and small children be assigned to the male or female sex by surgery? Does this impermissibly encroach upon the child's fundamental right to physical integrity and its right of personality, which includes the right to self-determination, reproduction and its own sexual and gender identity? What is the extent of the parents' right to consent to such surgery?
The persons affected emphasized the need to create a provision here which sets strict limits, since intersex persons suffer irreversible mental and physical damage as a result of this surgery. In addition, there was a call for better psychosocial care and counselling for those affected and for parents, as well as for improvements in medical care and in insurance.
More than one expert proposed that extensive information should be provided to educate the public and that the topic of intersexuality should be part of medical training. There was also discussion of the possibility of compensating those affected. The law of civil status requires the sex of a child to be registered at the same time as the birth; this was criticized, since it is impossible for parents to assign the child to the male or female sex, and many persons affected, even when they are adults, cannot assign themselves to a sex: instead, they feel that they are between the sexes or a third, different sex and would like to live in this way too.