Sex Reassignment Without Consent: The Lifelong Harm of Non-Consensual Medical Interventions

For decades, doctors performed surgeries on babies-babies who couldn’t speak, couldn’t say no-just to make their bodies fit a binary mold. These weren’t life-saving procedures. They were cosmetic fixes done without consent, often based on outdated ideas about what a boy or girl should look like. Today, we know better. But the damage remains. Thousands of people alive right now live with chronic pain, infertility, and trauma from surgeries they never agreed to. And the confusion? It’s still out there. People mix up these forced intersex surgeries with modern transgender care. They’re not the same. One is a violation. The other is a right.

What Actually Happened to Intersex Babies

Between the 1950s and early 2000s, it was standard practice in U.S. hospitals to surgically alter the genitals of infants born with intersex traits. These kids weren’t sick. They were healthy. But doctors, following the advice of psychologist John Money, believed that if you assigned a gender early and surgically reinforced it, the child would grow up ‘normal.’ So they cut, stitched, and reconstructed. Clitorises were reduced. Testes were removed. Vaginas were created. All without asking the child. Or the parents. Often, parents were told the child was ‘too damaged’ to live as they were, and surgery was the only option.

By the time the practice began to be questioned, over 1.7% of people-roughly 1 in 60-had been subjected to these interventions. That’s not rare. That’s common. And the results? A 2017 survey by the Accord Alliance found that 68% of intersex adults who had childhood surgeries suffered chronic pain. 42% had urinary incontinence. 55% struggled with sexual function. Many didn’t even know what had been done to them until they were adults. Some found out when they tried to have sex for the first time. Others found out when they couldn’t get pregnant. The trauma wasn’t just physical. 78% of those surveyed by Human Rights Watch showed signs of PTSD.

Why This Was Never About Transgender People

There’s a dangerous myth floating around: that transgender people were once forced into surgeries against their will. That’s not true. Modern gender-affirming care didn’t exist in its current form until the 1970s. Even then, it was voluntary. The World Professional Association for Transgender Health (WPATH) has required informed consent since its founding. Today, under Standards of Care Version 8 (2022), patients must undergo mental health evaluations, live in their affirmed gender for at least 6 months, and sign multiple consent forms. For minors, the process is even stricter. Denmark’s 2022 policy requires doctors to assess whether a young person has the cognitive and emotional stability to understand what’s being done. Not every minor qualifies.

What people confuse are two separate things: intersex surgeries on infants and transgender care for adults and older teens. The first is a violation of bodily autonomy. The second is a deeply personal, consent-based medical decision. When someone says ‘sex reassignment without consent,’ they’re usually talking about intersex babies-not transgender adults. Mixing them up isn’t just inaccurate. It’s harmful. It distracts from the real victims and gives cover to those who want to ban all gender-affirming care.

The Lifelong Cost of Forced Surgery

Think about this: You’re born with a body that doesn’t fit neatly into a box. Then, when you’re a baby, strangers cut you open and change you. No one asks you. No one tells you why. You grow up wondering why your body feels wrong, why you can’t feel pleasure, why you’re always in pain. That’s not a medical outcome. That’s a human rights crisis.

Research from the Center for Intersex Advocacy (2021) shows intersex adults who had non-consensual surgeries are 2.9 times more likely to suffer from depression and 3.2 times more likely to have anxiety than those who didn’t. Their suicide risk is higher. Their trust in doctors is shattered. Many avoid medical care entirely. One woman in California told researchers she hadn’t seen a gynecologist in 30 years because she was terrified of being cut again.

And the damage isn’t just personal. It’s systemic. Hospitals that performed these surgeries often kept records sealed. Patients couldn’t get their own medical files. Some were told they’d been operated on for ‘hygiene’ or ‘infection.’ Others were lied to about their diagnosis. In 2021, California passed SCR-100, formally apologizing to intersex people for these practices. It was the first state to do so. But apologies don’t heal. They don’t restore sensation. They don’t reverse infertility.

Redress Is Slow, But It’s Coming

Change didn’t happen overnight. It took activists. It took lawsuits. It took people speaking out when no one would listen.

Malta became the first country to ban non-consensual intersex surgeries in 2015. Germany, Portugal, and Greece followed. In the U.S., 14 states now have laws or resolutions protecting intersex children from unnecessary surgeries. California has paid out $4.7 million in settlements to victims since 2010. The European Court of Human Rights ruled in 2015 that denying gender-affirming care to adults is inhuman treatment. That case, Y.Y. v. Turkey, didn’t involve intersex people-but it set a precedent: your body belongs to you.

But redress is still uneven. Most victims never get compensation. Most never get an apology. And in places like Texas and Florida, lawmakers are now banning gender-affirming care for minors-even though the American Academy of Pediatrics says those bans increase suicide risk by 120%. Meanwhile, intersex advocates are still fighting for legal recognition that their bodies were wrongfully altered. There’s no statute of limitations on trauma.

What Modern Care Actually Looks Like

Let’s be clear: today’s gender-affirming care is nothing like what happened to intersex infants. It’s not rushed. It’s not forced. It’s not done on babies.

According to a 2022 University of Washington study of over 12,800 gender-affirming surgeries in the U.S., every single case followed WPATH protocols. That means: at least one mental health evaluation, six months of living in the affirmed gender, documented understanding of risks, and parental consent for minors. For surgeries, patients must have been on hormones for at least a year. Regret rates? Just 0.9%. A 2021 study in Plastic and Reconstructive Surgery Global Open reviewed 7,928 patients and found only 1% regretted their decision. Most of those who did regret it cited lack of family support-not the surgery itself.

And the outcomes? The Trevor Project’s 2022 survey of 34,000 LGBTQ+ youth found that transgender young people who had access to gender-affirming care were 60% less likely to attempt suicide. A Cornell University meta-analysis of 55 studies showed 93% reported improved well-being after transition. These aren’t abstract numbers. These are lives saved.

The Big Lie: That Consent Doesn’t Matter

Some critics point to a 2011 Swedish study that claimed higher suicide rates among transgender people after transition. But that study didn’t measure consent. It didn’t separate those who had support from those who didn’t. It didn’t account for discrimination, violence, or poverty. The researchers themselves said the elevated risk came from societal rejection-not medical transition.

Meanwhile, the American Medical Association, the American Psychological Association, and the Endocrine Society all agree: gender-affirming care saves lives. And consent isn’t a formality. It’s the foundation.

When someone says ‘sex reassignment without consent,’ they’re not talking about modern transgender care. They’re talking about a dark chapter in medical history-one we’re still cleaning up. The real question isn’t whether we should stop gender-affirming care. It’s whether we’ll finally stop harming children in the name of conformity.

What Needs to Change Now

Here’s what’s still broken:

• 14 U.S. states still allow non-consensual intersex surgeries on infants.
• Only 14 countries have banned them outright.
• Most hospitals still don’t have clear policies on intersex care.
• Victims often can’t access their own medical records.
• There’s no national compensation fund for survivors.

What needs to happen? First, every state should pass a law banning non-consensual surgeries on intersex children. Second, hospitals must open their records and offer counseling to survivors. Third, we need public education to stop confusing intersex rights with transgender care. They’re both about bodily autonomy-but they’re not the same fight.

And finally, we need to stop pretending this is a debate about science. It’s not. It’s about power. Who gets to decide what a body should look like? For too long, the answer was doctors. Now, the answer should be: the person who lives in it.