The Malta Independent 23 January 2020, Thursday

Busting the misconceptions around intersex with Tony Briffa

Dayna Clarke Wednesday, 11 September 2019, 09:09 Last update: about 5 months ago

Forty-nine years ago, when Tony Briffa was born, doctors didn't know whether she was a boy or a girl. After numerous medical tests to determine her complete biological sex characteristics (chromosomal, gonadal and hormonal) doctors decided that Tony would be raised as a girl.  She was named "Antoinette" and went to an all-girls school with her sister in the western suburbs of Melbourne, Australia. Despite a childhood involving extensive medical interventions, lies and old-fashioned attitudes about what it means to be a girl, Antoinette succeeded in her professional and personal life. 

However, after a life-changing experience, she decided to go public about her true self and that she was born biologically both female and male; that is, she was born with an intersex variation. The impact of this decision had significant consequences on her life but still led to her being elected as the first openly intersex public official in the world.

Tony has been a public intersex human rights advocate for 25 years and has been on the board of the AIS Support Group Australia for 20 years (including seven years as president). Tony is also one of two co-executive directors of Intersex Human Rights Australia and the Intersex chair of ILGA World. Prior to arriving in Malta, Dayna Clarke spoke to Tony to explore common misconceptions circulating intersex.


Why is intersex something people are afraid or ashamed of discussing?

People sometimes fear what they don't understand, but people accept intersex people when they know we are people born with biological variations that we can't control. We're just a natural variation in human biology.  My own experience shows most people are very accepting of me despite my intersex variation. That's why I've been elected three times to my city council and served my community as mayor, deputy mayor and councillor.

Why is the word hermaphrodite no longer appropriate to use for individuals?

Hermaphrodites are shown in pornography as having complete male and female genitals, but that is not what intersex is about.  In fact, most intersex people have typical genitalia for their sex. Only approximately 25% of intersex people have what is considered to be atypical genitalia.


The protocol that doctors are using to "treat" Intersex was developed by John Money more than 40 years ago. Do you think the protocol being used has negative results? If so, why do you think it is still being used given the bad results (wrong sex is assigned, anger later in life)?

The medical community blindly accepted John Money's treatment paradigm in the late 1960s despite it lacking evidence or peer review. When John Money and his research were discredited almost 20 years ago, medicine did not cease their destructive treatment protocol nor seek an evidence-based review. Instead, they buried their heads in the sand and continue to justify trying to "normalise" intersex babies and children despite not having a medical need for their surgical and hormonal interventions. For example, why should doctors surgically reduce the size of a baby girl's clitoris? There is no medical need to do that, so shouldn't they wait until the girl is old enough to decide for herself if she should have her clitoris reduced in size?


Do you think doctors are responsible for educating parents about what options they have to "treat" their intersex child? Are they giving them adequate information? Or do you believe doctors consider intersex to be a "medical emergency" that must be treated immediately?

Parents should be given access to peer support and accurate information about intervention options available and also the impacts of not having any intervention. The information provided should be impartial and objective and not frame intersex variations as a disability.  Importantly, parents also need to be given time to make decisions and not forced to make quick decisions at such a confusing, stressful and emotionally charged time.


Do you think that Intersex is a societal issue that doctors are trying to treat with a medical solution?

There are times when intersex people need medical assistance, but for the most part, intersex people need community awareness and understanding about our existence. Intersex people shouldn't be modified without our consent just to fit societal expectations of what girls and boys should look like and how they should behave.


What should be the new, better protocol for dealing with intersex? Do you think waiting is a better method? What are the negative and positive aspects of it?

The law should protect intersex babies and children from having their bodies modified for no medical reason. This includes protection for babies and children from being castrated, having their clitoris surgically reduced and having hormone injections. All of these interventions should wait until the child can provide consent. There are no negative aspects to waiting other than the child might decide not to have the intervention.


Is it true doctors assign intersex babies as female more than male?

The sex assignment for intersex babies is correct for the vast majority of cases, even though the assignment does not have to be surgically and hormonally reinforced. Most intersex people identify in their sex of rearing and are heterosexual. Some of us are gay, lesbian or bisexual, and some reject the sex they were assigned at birth. The sex of rearing largely depends on the intersex variation the child has. There are over 40 intersex variations and there are spectrums of differences within each one.


Do doctors consult a geneticist to determine the actual sex of the baby, XXY, XO, etc. before proceeding with surgery? Wouldn't that be more helpful in determining the correct sex of the child since the surgeries and hormone therapies are irreversible?

Some intersex variations are diagnosed at birth, some in puberty and some later in life. When diagnosed at birth, doctors conduct a number of tests to determine the child's chromosomal pattern, gonads and hormones. Sex can be assigned to a child without having to reinforce that assignment surgically. They wouldn't raise a child as a girl if they have male genitals, for example, but if a girl has a clitoris that is slightly larger than the norm, she should not have to undergo surgery without her consent to erase any intersex traits.  Surgical and hormonal intervention should only occur for a legitimate medical need and/or only when the person provides informed consent.


What kind of legislation or activism is taking place to increase awareness of intersex and to expand the rights of intersex individuals?

Malta is only one of a few countries that protect intersex children from these medically unnecessary surgical and hormonal interventions. Many intersex organisations and activists work hard to promote intersex human rights, awareness of intersex people and our issues, and to reduce the shame and stigma many intersex people still face. We also work to support families and individuals with intersex variations.


How do laws that stipulate that marriage is between a man and a woman affect intersex people? Do you think that the recent acceptance of gay marriages in countries such as Malta is welcome news?

Laws generally recognise intersex people as being either female or male, rather than treating us as a third sex. That said, it is much more preferable for laws to be inclusive of all people irrespective of sex or gender. My wife is Dutch and the Netherlands was the first country to introduce marriage equality. We married in New Zealand in 2013 when they introduced marriage equality there. Previously, I was in a straight marriage, but all marriages should be legal. It shouldn't matter if I am male or female to be able to marry my partner.


You have achieved so much, what's in the pipeline for you now?

I am looking forward to being in Malta for Pride Week! After that, I will go to Geneva for meetings with the International Lesbian, Gay, Bisexual, Trans and Intersex Association where I am a board member and chair of their intersex committee.

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