There is no evidence that "newer" surgeries preserve sensation or function. Indeed, because the surgery involves deep dissection and removal of highly innervated and vascular tissue, it is literally impossible for sensation to be unaffected. Outcome data from surgeries using similar microsurgical techniques for reconstruction after trauma in adults (for example, facial reconstruction, or transfer of a toe to replace an amputated finger) indicate that sensation is typically greatly reduced, but may be altered in character, or even painful.

Several people have come forward, whose surgery was performed during adolescence, and who are now young adults. Thus, they provide good information about surgical outcomes of only a decade ago. They report that surgery either greatly reduced or eliminated clitoral sensation, or left them with chronic pain. In some cases the pain did not develop until many years later.

Surgery inflicts emotional harm, by legitimating the idea that the child is not lovable unless "fixed" with plastic surgery that is medically unnecessary and carries great risks. Some individuals subjected to old style clitorectomy surgery were lucky enough to retain sensation. They find themselves no less emotionally harmed by the surgery. For examples, see (Coventry 1997; Coventry 1998; Holmes 1997) and the letter from Lisset Barcellos Cardenas to her physician in Lima.

Surgeons claiming to be developing the newest techniques concede that they have no proof that surgery does not damage sexual function. The published response of authors Oesterling, Gearhart, and Jeffs to (Chase 1996) concedes that their technique "does not guarantee normal adult sexual function."

There is even some evidence that the newer surgeries may be more harmful than the older ones. All of the cases of chronic genital pain that we are aware of are in patients who were subjected to "modern clitoroplasty" rather than older style clitorectomy.

4. Our recommendations represent the views of a large number of intersex people and the growing consensus of professionals in many disciplines.

ISNA maintains a mailing list currently numbering 1000 people. Of those, approximately 250 have told us that they, or a child, or a spouse is intersexed.

In the past several years there has been a world-wide explosion of intersex activism, with groups representing both intersex people and parents of intersex patients in many countries. See the Fall 1997 issue of the newsletter Hermaphrodites with Attitude for news from intersex patient-advocacy movements in New Zealand and Japan. The following are among the intersex patient-advocacy groups which criticize current medical protocols:

Intersex Society of North America

Ambiguous Genitalia Support Network (USA)

Hermaphrodite Education and Listening Post (USA)

Middlesex Group (USA)

Androgen Insensitivity Support Group (USA, UK, Canada, Germany, Holland, Australia)

Congenital Adrenal Hyperplasia Support Network (USA)

Intersex Society of Canada

Intersex Society of New Zealand

Peer Support for Intersexuals PESFIS (Japan)

Genital Mutilation Survivor's Support Network (Germany)

Workgroup on Violence in Pediatrics and Gynecology (Germany)

5. To date, no intersex person who was subjected to early surgery has come forth to say that the views expressed by these intersex patient advocacy groups are not representative, or to say that they believe genital surgery should be performed on intersex children.

6. Surgery cannot prevent psychological problems.

Indeed, in many cases it is clear that surgery itself is the cause of psychological problems. However, even if there were some former patients who felt that they were helped by early genital surgery, we would still argue that non-consensual genital surgery on infants is unethical, because so many people are harmed.