Bodily Autonomy, Dignity and Choice Act (SB 225)

Senate Bill 225 will allow people born with variations in their physical sex traits, many of whom identify as “intersex” to participate with their families in essential decisions about their own bodies. The bill delays non-emergency, irreversible and high-risk surgeries that seek to conform infants’ bodies to gender norms.

Approximately 1-2% of people are born with variations in their genitalia or other physical sex characteristics. The vast majority of these variations do not cause any harm that would warrant urgent modification, and most children born with these differences are able to live rich, fulfilling lives with the support of their families. Nonetheless, surgical procedures to conform these individuals’ bodies to cosmetic and social norms –- such as procedures to reduce a clitoris, create a vagina for penetrative sex, or move a working urinary opening so that a child can pee standing up — are still performed on infants under age two in California. SB 225 prohibits these surgeries on children under the age of six, unless the surgeries are required to address an immediate risk of physical harm.

There is a growing professional consensus that supports delaying these surgeries. International organizations such as the United Nations, the World Health Organization, and Human Rights Watch agree that these surgeries can be harmful and should only be done when the individual is able to weigh in on what is right for their body. Leading pediatric hospitals in the U.S., such as the teaching hospitals of Harvard University and Northwestern, have also begun to institute partial bans on these surgeries on patients who are too young to participate in a meaningful discussion of the implications and risks. And the American Academy of Family Physicians has condemned the continued performance of these surgeries on young children.

For every person, identity and sense of self — including gender — can evolve over a lifetime, but these surgeries performed on infants are permanent. Individuals with variations in their physical sex characteristics living with the results of genital surgery performed in their infancy often deal for the rest of their lives with the emotional and physical consequences — including pain during intercourse, being unable to experience orgasm, problems with intimacy, and severe depression.

SB 225 provides families and their children more autonomy over these decisions by delaying surgeries until the child has reached six years old. Research shows that the age of six is a time that, for many, gender identity has begun to form and take shape. A delay until a child is six therefore provides parents the opportunity to observe their child’s development and perspective on their own body, permits the child to participate in a decision about surgery, and reduces preventable harm to children born with variations in their sex characteristics.

SB 225 is cosponsored by Equality California, interACT: Advocates for Intersex Youth, the National Center for Lesbian Rights, and the ACLU of California Action.