The truth, when it finally came, was both liberating and traumatizing: Bo discovered she had been born with atypical genitalia, which surgeons had operated on to make her look—arbitrarily—more typically female, inflicting irreversible harm on her in the process, and telling her parents that they should never reveal to Bo the surgery she had undergone as an infant.
But after learning the truth from her medical records, and as she traveled the country telling her story, she found this was untrue. Her California mailbox began to fill with letters from people describing similar experiences. The procedures are irreversible, severed nerves cannot regrow, and scar tissue can limit options for future surgery.
Bo and the other early ISNA participants believed the truth would soon set them—and future generations of intersex people—free. Convincing the medical establishment proved to be significantly more complicated than anyone expected. A change in medical paradigms requires a shift in understanding what the medical evidence shows—in this case, an acknowledgment that, although empirical data remains incomplete, there is now substantial evidence that medically unnecessary surgery on infants and young children with intersex traits often causes significant harm.
Conversely, there is little evidence of its putative benefits, and certainly no empirical basis on which to conclude that the supposed benefits are real, let alone that they outweigh its harms. The medical paradigm that ISNA was up against had calcified in the US in the s when John Money, a psychologist at Johns Hopkins University, theorized that gender in infants was malleable and surgical interventions could unproblematically determine lifelong gender identity.
The outcome was, in fact, disastrous. The child had, in fact, not grown up to identify as a woman, but a man—and transitioned in his 20s. The default-to-surgery paradigm, however, had already become entrenched and, in fact, was already being exported around the world. This was their tactic to move the needle and start advocating to help intersex adolescents and adults seek the care they actually wanted.
