Change law to ban sex surgery on infants, professor says

EXUAL reassignment surgery should not be carried out on infants, Dr Milton Diamond said at a recent public lecture at the Victoria University law faculty. Dr Diamond's lecture, entitled legal and ethical issues in the treatment of gender variance in children and adolescents, was jointly sponsored by the law faculty and the Ministry of Social Development. The lecture gave an insight into how surgical treatment, including sex reassignment surgery for intersex infants, became a routine recommendation of practitioners, and how parents were persuaded to consent to such radical procedures. Parents, however, should not be able to consent to such surgery, said Dr Diamond, a professor at the John A Burns School of Medicine at the University of Hawaii. "The informed consent must be from the individual - the infant," he said. "Parents should not have the right to remove from the child what we call an open future. It's about preserving the child's right to self-determination." Following the lecture, Dr Diamond gave LaioTalk his thoughts on how this related to the law. Currently, he said, physicians could do what they wanted and a law change would be needed to require that they were not able to perform surgery without the informed consent of the patient. "I don't know New Zealand law. I suppose they must have informed consent, so I suppose they gain the consent of parents." During the history of sexual reassignment surgery, something Dr Diamond describes as providing "a cautionary tale that is relevant both for medicine and law", physicians had argued a series of justifications that were neither medically nor scientifically valid. One example was removing testes on the basis of the incidence of tumours. However, the incidence of testicular tumours was around 2%. The incidence of breast cancer was about 20%. "You don't go around routinely doing prophylactic breast removals," Dr Diamond said. "You wait until there is a sign of something happening. The same with testes." A very good test of whether surgery should be carried out is known as the "thank you" test. This asks the question whether the patient would thank the surgeon for the procedure or not. "If you have a cleft palate and have surgery, the majority of people say 'thank you'. However, the majority of intersex people say 'no thank you' to sex reassignment surgery." Sohowshould thelawbechanged? Should sex reassignment surgery undertaken without informed consent be a criminal act, or should it be something for which a practitioner faces a disciplinary body of his or her peers? "All of the above," Dr Diamond said. "Whatever has to be done to stop it. I don't want it to happen."

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