Spike Poma underwent surgery on his testicles within 24 hours of birth, which neither he nor his relatives approved of. The 21-year-old Polk County resident claimed that the procedure only caused difficulties and ongoing pain, despite physicians’ claims that it would make Poma appear more feminine.
According to InterACT, a nonprofit organization that advocates for intersex rights, the term “intersex” refers to anyone who is born with an array of variants in sexual characteristics that fall outside the conventional notions of male or female bodies. The genes, genitalia, and internal organs of intersex people may vary. According to the Cleveland Clinic, one in every 100 Americans, or about 2% of the world’s population, possesses intersex characteristics. However, not all intersex characteristics are obvious at birth, and a person may go their entire life unaware of their intersex status.
Florida has introduced numerous bills over the past few years that have been aimed at the transgender community, including ones that restrict access to gender-affirming healthcare and are now attempting to define biological sex in a way that would make them illegal. Intersex people have been put in the middle of this, frequently finding themselves misunderstood by the government or having their needs completely disregarded.
According to Justin Tsang, an intersex expert and research director at The Eastern Americans with Disabilities Initiative, these bills are misinterpreting sex because they believe it is based on reproduction, chromosomes, and genitalia. They even believe that sex and other factors are the same.
The language is ambiguous, even though some laws, like those addressing health care and bathroom access, appear to try to give intersex people access to facilities and areas that the state has either restricted or outright outlawed for them. Additionally, personal situations like Poma’s can be more complex than the law permits.
Although an intersex person may be transgender, this does not imply that their gender is different from the gender they were assigned at birth. However, advocates claim that laws that attempt to define physiological sex have an effect on both areas. They have the potential to revoke people’s access to reliable identification documents, obstruct medical care, or even send them to jail for using the “wrong” restroom.
Laws: Intersex and transgender people are not included in strict definitions of natural sex.
Advocates claim that Poma’s experience as a child is typical of intersex people. Doctors often perform preventative surgeries to make the baby appear more generally male or female when they are confronted with a clearly intersex baby in an effort to determine which gender they most closely align with. Advocates speak out against these procedures, which are frequently carried out during adulthood or early childhood, because they can lead to future health issues and because doctors frequently underestimate how a child may develop sexually.
Poma claimed that he displayed signs of being intersex during his childhood. He was already out as a transgender boy when he was physically assaulted before playing basketball in his teens, and at that point, the man was aware of his intersex status.
Poma has experienced health problems with unbalanced hormone levels that led to inner pain. He claimed that taking hormones as a transgender man helped to balance his hormones. But when Senate Bill 254, which limited who could and could not prescribe hormone replacement therapy and various gender-affirming care to transgender people in Florida, was passed last year, he was denied access to that treatment. For about seven months, he hasn’t been able to produce testosterone.
He added that he has regular internal bleeding and that “Being off of it for so much, I’ve slowly started getting those health issues back.”
A carve-out for intersex people is created by SB 254, which states that a doctor may treat if the patient has “external genetic characteristics that are unresolvably ambiguous” or “if it has been determined through genetic or biochemical testing that they do not have the normal chromosome structure, the production of steroid hormones, or the action of steroids for either sex.” Poma was receiving hormones in the form of gender-affirming treatment through a nurse practitioner, which SB 254 forbade, even though he essentially would still be eligible under that carve-out. He claimed that it has been difficult to find a new provider.
Additionally, the law does not use the term “intersex” but rather “disorder of sexual development,” which InterACT refers to as “controversial and pathologizing.”
House Bill 1521, another law that was passed last year, forbade transgender individuals from using gender-appropriate restrooms and changing facilities. Intersex people were exempt from the law’s terms, but anyone who perceives a transgender man is in the “wrong” facility may demand that they leave. They risk being detained if they don’t.
Quinn Diaz, a policy associate for Equality Florida, said that “we’re seeing intersex people experience harassment in the bathroom by people thinking they might be transgender.” “As a result, all of this fear, confusion, and mistake is being stoked, which has led to families starting to
despise one another.”
With the apparent goal of replacing the term “gender” with “sex” in various Florida statutes, particularly those related to identification documents like driver’s licenses, two bills this year seek to define natural sex.
House Bill 1639, one of the bills, is currently in its second committee and makes no mention of intersex individuals. Advocates of House Bill 1233, which was in the Health and Human Services Committee as of January 13 and refers to “an individual born with a medically verifiable diagnosis of an individual’s disorder in sexual development,” assert that intersex individuals “must be provided constitutional protections and accommodations afforded under the Americans with Disabilities Act and relevant state law.”
According to Tsang, the Americans with Disabilities Act defines disability as a functional limitation. There are some intersex individuals who suffer from both disability and variations, but most of the time, they are functionally unrestricted. Therefore, they wouldn’t be ADA-eligible for accommodations.
Both bills define the male and female sexes primarily in terms of sexual roles, which Diaz referred to as an “anti-science” approach.
They claimed that “it is largely based on this Christian nationalist appeal to the far right.” “To the wind with science and all the health interpretations that we’ve been able to gain over the past 150+ years, bringing in those definitions of sex that are entirely based on one’s anatomy.”
An effort to “normalize”
Both bills also aim to prevent people from having their sex designations changed on their driver’s licenses, stating that they should just show the sex that was assigned to them at birth. The Florida Department of Highway Safety and Motor Vehicles issued a letter at the end of January stating that gender markers may no longer be permitted to be changed and that doing so would be considered fraud, even though neither law has yet been passed.
Both transgender and intersex people are worried about interference with their day-to-day lives because they fear being violently identified at this time.
Poma claimed that his license bears a female marker and that he needs more generally male accommodations when seeking medical care. This could be a problem in an emergency.
“They frequently use your sex symbol to identify the accommodations you require in a clinical setting if you aren’t fully conscious or aware of your surroundings when you enter,” he said. “And for someone who is more biologically male-leaning but still exhibits some female characteristics, they frequently only (give me) female accommodations and won’t give me any male accommodations, which can frequently be harmful to my health.”
Concerns exist regarding the effects of laws like SB 254. Despite the fact that nearly all significant medical associations in America supported the treatment provided to children, lawmakers repeatedly raised concerns about transgender children during last week’s hearing, calling it castration, mutilation, and child abuse.
Also, transgender children rarely have surgery; in fact, the Endocrine Society advises against having genital or reproductive organ surgery on children under the age of 18. However, it is common for intersex children, such as Poma, to undergo non-consensual corrective surgery at a young age.
According to InterACT, the majority of these procedures are never medically necessary and can be postponed until the patient is old enough to consent. In addition, there is mounting evidence that these surgeries can be harmful, such as pain, loss of genital sensation, scarring, incontinence, and more.
“They ‘are’ sort of reiterating that it’s acceptable to perform surgeries on intersex people who are too young to consent, and they also lose their physical autonomy. However, Tsang also said that they disregard the autonomy that transgender people want in order to obtain the hormones and surgeries they desire.”
Present laws and bills have a chilling effect.
Doug Bankson, R-Apopka, the bill’s co-sponsor, stated that his act was filed out of “compassion” during a House committee reading for HB 1639. The bill would attempt to define biological sex and mandate that insurance companies pay for conversion therapy. It would also require official documents, such as driver licenses, to record a child’s sex at birth.
People of transgender and intersex do not consider it to be compassionate.
Since it went into effect in July 2023, HB 1521, which prohibited using the restroom, has not resulted in any arrests, according to Diaz. However, it has a terrifying effect on Florida’s transgender community.
Its overall effect, according to Diaz, is to “only chill behavior, to make people afraid to participate in public life, and I think that may likely extend to transgender people as well.”
Poma opposed HB 1639 in a speech delivered in January in the nation’s capital. But it’s not just the policy from this year that worries him.
A previous version of SB 254 contained ambiguous language regarding the state’s emergency jurisdiction over a minor who was “subjected to” gender-affirming treatment. Poma recalls that the language was so ambiguous that he was worried that having a close transgender family member might endanger his relatives who are also gay, forcing him to stop communicating with them for their safety.
Even though that provision of the law was not passed, it still haunts him, particularly now that he lives in Florida without access to hormones and without a valid driver’s license.
“Imagine waking up every day to someone telling you to describe why you woke up, why you’re breathing, and how you chose to get out of bed rather than pass away,” he said. “There will always be people who would prefer for us to be dead on the side of the road than to see us happy in our normal environment, even if it’s just in a supermarket business. It really is only fighting to survive at this point.”
Today’s lead writer at FLORIDA is Finch Walker. Walker can be reached at fwalker@floridatoday.com. Twitter: @finchwalker
