Intersex surgeries halted during COVID-19

By Lungelo Ndhlovu

Bulawayo, 7 August: Surgeries for intersex people in Zimbabwe have been indefinitely postponed due to the Corona Virus pandemic, acting Chief Executive Officer of Mpilo Central Hospital Professor Solwayo Ngwenya told Gender Links in an exclusive interview.

Intersex people are born with sex characteristics (including genitals, gonads and chromosome patterns)
that do not fit the regular  binary notions of male or female bodies. Some intersex people undergo surgical procedures to more closely align their sexual characteristics with those commonly associated with their gender identity but many Intersex people are opposed to unnecessary medical surgeries, according to intersex experts.

Mpilo Central, the largest hospital in Bulawayo, launched a gender-affirming surgeries register for people with ambiguous genitalia last year (2019). “The surgeries for intersex patients are deemed elective in nature, meaning their conditions are not life-threatening, hence not emergencies, so they are suspended,” Professor Ngwenya said.

Last year,  Mpilo hospital attended to 12 people aged from three weeks to 42 years old who came to the hospital for the ‘first screening sessions’ for intersex clients with genitalia ambiguity, and clients were coming from Harare, Mashonaland West, Plumtree, Nkayi and Bulawayo.

But, it must be noted that the suspension of intersex operations due to COVID-19 is not only happening in Zimbabwe alone but across the globe. In some respects COVID-19 has brought a halt to these unnecessary medical surgeries, often performed on children without consent, says Crystal Hendricks Coordinator for Intersex South Africa.

However, Intersex persons have been demanding that their bodies be recognised as a gift from God and requires no medical interventions, as the world is not only made up of men and women, but of intersex people too, says Hendricks.

As COVID-19 flips over the daily lives of people around the world, United States (US), federal medical bodies and figures recommended that elective, non-essential surgeries be suspended in order to prioritise the use of healthcare facilities and equipment for treating patients with COVID-19, on 23 April 2020, according to the Child Rights International Network (CRIN).

Also gender affirming surgeries  which are largely a request from Transgender persons and are often not covered by health insurance are proving difficult to access  Transgender people travel all over the world in order to access different surgery procedures. This is proving difficult due to COVID-19 travel restrictions.

Sam Ndlovu, Executive Director for Trans Research Education Advocacy and Training (TREAT), and also the Vice Chairperson of the Southern African Trans Forum, said gender affirming surgeries performed by medical doctors on intersex and transgender individuals based on the notion that they are “correcting” a person is wrong.

“It is a shame that people who do not go through understanding what these conditions or states of being mean or how it affects them are the ones directly commenting about whether it’s a need. It’s totally unfair,” he said in an interview.

Trans Specialist Sibusiso Kheswa, who works under Iranti, an organisation formed in 2012 to help local and regional lesbian, bisexual, queer, trans, intersex and gender non-conforming (LBQTIGNC) movements in Southern Africa, weighed  in on the  matter by urging  all countries who subscribe to international bodies like the World Health Organisation (WHO) to take the guidelines provided by the WHO seriously.

“The WHO says everyone has the right to health and nobody should be left behind. In that case it means as transgender people we are entitled to our health, and to gender affirming health care,” Kheswa said in a telephone interview.

In a situation like a pandemic where health services for transgender people are postponed or cancelled, serious mental health issues can arise, Kheswa added.

“Governments must protect the rights of Intersex persons and abide to the Yogykarta plus 10 principles which calls on governments to protect people regardless of the sexual orientation, gender identity and sex characteristics. Hence there is no bodily disorder that needs correction, Intersex people must be protected from such medical abuse,” Kheswa further noted..

Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI+) people may be particularly vulnerable during the COVID-19 pandemic, according to a report from the United Nations Human Rights High Commissioner’s COVID-19 Response.

The report indicates that homeless LGBTI+ people, for instance, are less able to protect themselves through physical distancing and safe hygiene practices, increasing their exposure to the coronavirus.

Hendricks,further noted that the corona virus has added more challenges for intersex people who have long been considered non-essential when it comes to accessing health care.

“Intersex people have always been marginalised and medically pathologized because the medical sector believes that intersex people need to be ‘fixed,” Hendricks said.

Hendricks is of the view that in most cases intersex correctional surgeries are meant to erase intersex people to fit into boxes, and the pandemic even makes marginalisation of intersex people even worse.

“They often get misinformation about their bodies, and this leads to harmful practices like intersex genital mutilation. This adds more stress, making things so much harder because intersex and trans people have been considered non-essential when it comes to access to health care.” Crystal explained.

Sylvester Nyamatendedza, the Services and Policy Advocacy Officer at GALZ, an association of Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI+) people in Zimbabwe, told Gender Links in a telephone interview, prior to COVID-19, LGBTI persons in the country, were already facing challenges in accessing Sexual Reproductive Health Rights (SRHR) services.

“With the coming of COVID-19 and the national lockdown regulations put in place by authorities, the problems have exacerbated. Military assisted or police manned roadblocks have restricted LGBTI members to travel and access SRHR services found in the Central Business District (CBD),” Nyamatendedza said.

He noted that on the roadblocks, authorities will require letters or passes from individuals, acting as permits to allow people entry into the Central Business District.

“To get one such a letter could be a problem,” Nyamatendedza said, indicating that GALZ have since come up with some initiatives including, opening a two-day clinic at their Harare office to try and manage the situation.

“In other cases we are now doing accompanied referrals where we mobilise people by arranging transport for them but at the same time making sure that we are abiding by COVID-19 regulations put in place by authorities,” Nyamatendedza said indicating that some challenges goes beyond SRHR issues such as substance and alcohol abuse as a way of dealing with the challenges.

Lungelo Ndhlovu is a multiple-award winning international  journalist based in Bulawayo, Zimbabwe. This story is part of the GL News Service Gender and COVID-19 news series.