On December 11, 2003, intersex Filipino Jeff Cagandahan filed a Petition for Correction of Entries in Birth Certificate before the RTC, Branch 33 of Siniloan, Laguna. Assigned female at birth, Cagandahan specifically asked to change his name and his sex (from female to male) in all his legal documents after he developed male characteristics while growing up because of a condition called Congenital Adrenal Hyperplasia (CAH).
Cagandahan’s case reached the Supreme Court, which – in 2008 – sided with Cagandahan.
In its decision, the highest court stated that “ultimately, we are of the view that where the person is biologically or naturally intersex the determining factor in his gender classification would be what the individual… thinks of his/her sex… The Court will not dictate on respondent concerning a matter so innately private as ones sexuality and lifestyle preferences, much less on whether or not to undergo medical treatment to reverse the male tendency due to CAH… Respondent is the one who has to live with his intersex anatomy. To him belongs the human right to the pursuit of happiness and of health. Thus, to him should belong the primordial choice of what courses of action to take along the path of his sexual development and maturation.”
The decision on Cagandahan’s case may have been released approximately 13 years ago; but intersex people, including in the Philippines, continue to be largely under-the-radar. And this, according to Aaron Moises Cerico Bonete, concurrent managing editor of Outrage Magazine and Bahaghari Center for SOGIE Research, Education and Advocacy, Inc. (Bahaghari Center), is “something that needs to be remedied.”
“Most people still think in binaries,” said Bonete. Meaning, “when tackling SOGIESC, these people always revert back to ‘only’ male and female; also including when thinking of biological and genetic characteristics of people.”
This is, he stressed, obviously wrong.
“There are many people around the world who actually have sexual characteristics that do not fit typical binary notions of male or female bodies. And many of these people identify as intersex.”
And so, yes, intersex – the general term used to refer to individuals born with, or who develop naturally in puberty, biological sex characteristics which are not typically male or female – continues to be misunderstood.
Intersex is an umbrella term used to describe a range of natural variations that affect genitals, gonads, hormones, chromosomes or reproductive organs. Sometimes, these characteristics are visible at birth. Sometimes they appear during puberty. And sometimes, they are not physically apparent at all.
What needs stressing is that “being intersex relates to biological sex characteristics, and is distinct from a person’s sexual orientation or gender identity. An intersex person may be straight, gay, lesbian, bisexual or asexual, and may identify as female, male, both or neither,” stressed the UN Free & Equal (2017).
The exact percentage of people born on the intersex spectrum is difficult to quantify.
The American Psychological Association, for example, mentioned that 1 in every 1,500 babies is born with genitals that cannot easily be classified as male or female. However, according to the APA, intersex conditions are not always accurately diagnosed, experts sometimes disagree on exactly what qualifies as an intersex condition, and government agencies do not collect statistics about intersex individuals.
For the Human Rights Watch (2017), it is generally accepted that 1.7% of newborn babies have different sex characteristics from what is typically called a boy or a girl. Sadly, it is estimated that 1 in 2,000 babies are different enough so that doctors may recommend surgical intervention to make the body appear in line with social expectations.
The aforementioned forced surgery is – obviously – only one of the many issues facing intersex persons. These issues also include: erroneous giving of names and genders in legal documents like birth certificates (similar to Cagandahan’s case), the discrimination encountered due to their being different, lack of specialized medical services, etc.
There is a need to “talk about this,” said Bonete.
LAYERS OF ISSUES
Interviewed by Outrage Magazine, Cagandahan, the intersex Filipino who filed the case that reached the Supreme Court – and who eventually co-founded Intersex Philippines – said that there remain numerous. misconceptions on being intersex.
For one, there’s the belief that intersex people are – using the old/outdated and largely denounced term – “hermaphrodites”, insinuating that intersex people have the genitals of both sexes. “There are intersex people with penis and vaginal opening, but there are no documented cases of a person with fully-developed, fully-functioning male and female genitalia,” Cagandahan said.
He added that “there are over 40 variations of the intersex condition, and true hermaphroditism (or someone with ovarian and testicular tissues) is only one of them. The misconception is, if you’re intersex, you have both (fully-functioning genitals); and this isn’t the case.”
Secondly, “another misconception is (the belief that) intersex is very rare,” he said, adding that doctors often say this. “But according to data, 1.7% of the general population are born with intersex traits. In the Philippines, (this totals an estimated) 1.7 million people who are born with intersex traits.”
Considering the number, why don’t people hear about the intersex community?
“Because of the discrimination,” said Cagandahan. There are intersex people who “prefer to hide.”
And thirdly, there are many who believe that “intersex is a condition that needs to be corrected.” Cagandahan noted that many intersex children are forced to undergo surgery in an effort to “normalize” them. “But these surgeries are performed on people still too young to make informed decisions on their own bodies,” he said, adding that “surgery is often done only to amend one’s body aesthetically, for it to fit the ‘normal’ perception of male or female bodies.”
For Cagandahan, the terms used related to intersex people should also be amended – e.g. when it is considered as a “disorder”, thereby in need of fixing, even if this isn’t the case. “Every intersex person is unique and do not need fixing,” Cagandahan said. Instead, “fix your hearts, not our parts.”
DEALING WITH MULTI-LAYERED CHALLENGES
“I don’t think the government is doing anything right now (to address the issues of the intersex community in the Philippines),” Cagandahan said, adding that “unfortunately, the Philippine is still not intersex-friendly.”
The decision on his case came out in 2008, and yet “there are still no laws protecting the rights of intersex people.”
Not surprisingly, community-based organizations are doing the hard work – e.g. Intersex Philippines, for example, is helping raise awareness about the intersex community here. Obviously, such efforts can only go so far.
Specific to the medical field, for instance, those there “need to educate yourselves (about intersex issues),” Cagandahan said. There are – as examples – instances when intersex people just stop going for check-ups because of how bad their experiences could get while accessing medical care. If medical professionals also become more aware of the issues faced by intersex people, they’d be better equipped to discuss these with parents, recognizing that – even if they recommend surgeries to “fix” intersex conditions – they’d also know that “it doesn’t stop there; people need to be informed of the life after surgery.”
It could also be helpful if there are centers catering to intersex variations. This will make these services readily available to people, particularly those who may not be able to afford accessing the same out of the country.
Meanwhile, “to make law intersex-friendly, lawmakers should consult with the intersex community,” Cagandahan said, “especially on laws that affect us.” But lawmakers should also study including intersex as a third sex category in legal documents to: limit surgeries on intersex babies just so they’d fit the sex binary of male or female; as well as passing gender recognition law to hasten – not just make affordable – processes for intersex Filipinos to amend their gender markers, as needed.
HOLDING THE LGBTQIA COMMUNITY ACCOUNTABLE
The intersex community is included in the LGBTQIA acronym. But this does not immediately mean they are represented in the community, admitted Cagandahan. True, there are now more efforts that are intersex inclusive; but “they need to integrate the ‘I’ more into their work,” he said. “Always invite intersex people to speak about the intersex experience; they need to link us with other networks; etc.”
But intersex people may also need to step up.
“You don’t need to come out to help,” he said. “Start with your families. Because if you just hide, our stories won’t be heard. We need to do more for the community. We’re a minority in the minority LGBTQIA community; so let’s take action.”
Cagandahan added: “We are here; we exist. We have the same rights as yours. Our bodies are not wrong. So we encourage everyone to respect our diversity. Hear our stories to fully understand our issue.”
TIME TO HIGHLIGHT
The population of the Philippines is pegged at 110 million – give or take. And 1.7% of that totals 1,870,000.
“And if we believe the estimate on the percentage of people born on the intersex spectrum, that’s the number of those belonging to the intersex community in the Pilipinas, whether this is diagnosed or not, or whether these people may be aware of their intersex condition or not,” said Bonete.
More importantly, though, “no matter the actual figure, what’s important to remember is this: They exist; they are part of the community. Meaning: attention should already be given to their needs – from access to good – and yet affordable – medical care that will address needs specific to the intersex community; to easier – and affordable – processes for them to change their legal documents; to the continuing inclusion of the intersex community in the LGBTQIA acronym, even if they do not necessarily get a chance to speak about their particular issues.”
And for Bonete, if they are ignored, then we become enablers of abuses of those in minority sectors. “And this is something worth confronting.”