Intersex for Mental Health Professionals
Like many people under the LGBTIQ+ banner, intersex people experience a higher incidence of mental health issues , self harm and suicide, along with higher than average rates of poverty, disability, and lower participation in higher education. This is as a result of a social phenomenon called ‘minority stress’. Minority stress describes the social and emotional impact that comes from being marginalised or discriminated against.
It is therefore important to shift understanding from the assumption that being LGBTIQ+ somehow intrinsically causes these problems, to placing the responsibility with society. Social and mental difficulties arise as a response to social hostility, rather than being somehow innately consequential. As such, it is the job of mental health professionals to support their intersex clients, and to shift attitudes in society.
Due to the legacy of pathologisation that is attached to intersex conditions, and societal perception that there is something ‘wrong’ with intersex people, rather than simply understanding intersex status as a simple and natural variation of the human body, intersex people often experience stigma and shame. This stigma can have a powerful impact on family dynamics, and result in intersex people finding themselves either estranged from family members, or the source of family conflict. Under such circumstances, offering mediation can be an appropriate solution – as long as it is the desire of the intersex person.
Many intersex people are the victims of non-consensual surgical and other medical procedures in infancy. There is a legacy of doctors performing operations on intersex infants to alter the appearance of their genitals, to greater achieve physical ‘binary conformity’. Depending on the experiences of the intersex person, it is entirely possible that they have experienced trauma as a consequence. As medical intervention has often been at an early age, an intersex person might not have specific memories of medical procedures – nonetheless, they may well still consider the intervention to be a source of trauma. Indeed, some schools of thought believe that somatic trauma remains in the body, even if the memories do not. This trauma must be understood as an ongoing process with long-reaching consequences. For older victims, memories of invasive tests and procedures, difficulties with doctors and time spent in hospital can be awful and humiliating memories.
Care should be taken not to conflate intersex issues with gender identity. Some intersex people may seek out gender-affirming healthcare (such as hormones or surgeries), but this may be experienced very differently to a trans or gender diverse person, and the person may contextualise their wishes very differently. What might be appropriate assessments of desire to transition in transgender people might completely undermine an intersex person’s path to reaffirming their own gender identity. It is important to establish a context that understands an intersex person on their own terms.
Intersex people seek the services of mental health professionals such as counsellours and therapists for a variety of reasons, just as those without variation do. It is best to not make assumptions that intersex clients have come to therapy to discuss issues related to their intersex status, and their status and related issues should only be discussed if they raise it themselves.
- Social and emotional difficulties arise for intersex people as a response to social hostility, rather than being somehow innately consequential. It is therefore an important role of mental health professionals to support their intersex clients and to shift attitudes in society.
- Social stigma can have a powerful impact on an intersex person’s family dynamics, and can relate in family estrangement or social isolation.
- Care should be taken not to automatically conflate intersex issues with gender identity.
- Many intersex people are not aware of, or else are untroubled by their intersex status and simply seek mental health services for unrelated reasons.