Working together to achieve a good level of healthcare – tips and advice for medical personnel

Healthcare for intersex people

Even if you have been taught about what is sometimes termed “DSD” during your medical studies or healthcare training, it is important to know that the first meeting with an intersex patient is often an anxiety-inducing occasion. We have therefore compiled some information about inter* people.

Intersex people often associate hospitals and doctors’ surgeries with memories of humiliation and disinformation. Some of them have had to go through examinations and investigations which were not justified by a therapeutic objective that was tailored to their needs. Or their genital area was put on show for the benefit of medical students or colleagues of the doctors carrying out the treatment. If they were subjected to gender reassignment surgery without their consent, they will probably be suffering from the long-term effects of this and/or from receiving hormones that became necessary as a result of the procedure.

Some intersex people try to avoid visiting their doctors because they are afraid of being badly treated or becoming traumatised all over again.

Working together to provide high-quality treatment

Viewed within the context of these types of patronising or violating experiences, it is absolutely critical that inter* patients are seen as people with the right to self-determination and information. It is also important to understand that they also have expert knowledge about their own bodies.

  • If physical examinations are required, ensure that you explain in advance their purpose and the individual steps in the process. Ensure that you obtain their consent and pay particular attention to the way your patients respond during the examination to ensure they are not displaying signs of discomfort. Do not hesitate to suggest any ideas you may have for less invasive examination methods. 
  • Put your personal or professional interest in intersex to one side and focus on the specific concerns your patient would like you to address. You may perhaps require specific information concerning the patients’ sex characteristics or medical history in order to provide them with the correct treatment. If this is the case, make an active effort to clearly explain why you need to ask these questions.
  • Ensure that you use respectful language, and do not disparage your patient’s body or give the impression it is deficient in any way. You can find further information on how to interact with your patients in a responsible way here.
  • Find out as much information as you can about the different therapeutic options, for example, the choice and dose/dosage of replacement hormones. Ensure that decisions are made that are tailored to the patient’s specific requirements as stipulated in the relevant medical guidelines.
  • Put aside any preconceptions you have about what is important to intersex people. For example, hair growth that conforms with conventional gender roles may be less important to them than their general health and well-being.

Knowledge and further education

Intersex bodies, patient histories and concerns can vary considerably. It is likely that you will not be able to draw upon past experience in each and every specific situation.

Many inter* people have acquired extensive knowledge about their bodies and want their clinicians to speak openly with them about the things they feel uncertain about and to develop solutions which focus on their specific physical situation and needs, rather than according to conventional male or female norms. If your patients have questions regarding social or legal issues, you can also point them towards inter* organisations and peer counselling services or find out more information yourself from these services.

This text has been published with the kind permission of the Regenbogenportal and has not been edited in any way. This online information service, which focuses on same-sex lifestyles and gender diversity, provides a range of information to support lesbian, gay, bisexual, trans and intersex people:  https://www.regenbogenportal.de/.