Fighting for intersex liberation: a conversation with Juliana Gleeson

In this interview with Alex Stoffel, Juliana Gleeson argues for deep interconnected involvement between the intersex, trans and feminist movements, fighting against harms caused by the state, the medical establishment and families together

AS: To start us off, could you give readers a sense of what Hermaphrodite Logic is about? What drew you to write a history of intersex liberation, and what felt missing from existing accounts?

JG: Hermaphrodite Logic tells the history of a political struggle, one that started in the 1990s and originally set itself up against the clinical mistreatment of intersex people. I wanted to know how they staged that challenge and why then (…why the 90s?) My book is one of many recent histories of sex and gender and their development (I can think of perhaps a dozen scholarly books which try to tell that same story!) But Hermaphrodite Logic tries to move a long way beyond just seeing sex and gender as a set of concepts or medical ideas. ‘Intersex’ treatments are never just ideas rattling around in the heads of medical practitioners, or natural sciences researchers. They were really a meatgrinder that both children and parents were arranged around.

Too often, these gender-sex histories basically leave those so-called sexologists as the protagonist—not intersex people, or intersex politics. Specifically, Hermaphrodite Logic is about the struggle of intersex people to follow their own expertise and reset their own destinies, which followed directly from their efforts to recognize one another as intersex. No sooner did intersex people start talking to one another, than doctors found themselves facing a ferocious challenge to their authority. Out of the very earliest attempts to build intersex communities came a bold new challenge to the ways that they’d previously been routinely (mis)treated. So more simply: my focus is on intersex communities coming to rewrite the science of sex. And deliberately…John Money appears only as the antagonist of Hermaphrodite Logic.

Now, second question: how did the intersex movement stage those arguments? The arguments made by the very first organisations of intersex people (from the mid-90s til today) were both unmistakably edgy, and already quite sophisticated. Edginess was typical for the times (with groups like Queer Nation, Lesbian Avengers, Outrage! and ACT-UP sharing both tactics and slogans with the early intersex movement). Groups like the Intersex Society of North America and later Switzerland’s Zwischengeschlecht focused on picketing paediatric conventions, effectively forcing confrontations between medics and their former patients (which is where I start the book.)

AS: Hence the book’s title? I know many intersex people consider that word a slur…

JG: Yes! And in the 90s, they were eagerly ‘taking it back’. As I read them, early intersex advocates were both provocative, and quite cold-blooded—one might say numbed. I tried to capture both faces of that in the book’s title—a homage to a bygone style found in VHS tapes titled Hermaphrodites Speak! Or their special issues of queer mag called Intersex Awakening. This is a calculated edginess, delivered judiciously and without losing one’s cool.

So the book is really an intellectual history of the intersex movement. As I put it: how intersex consciousness rewrote the hitherto existing history of sex. HermLog provides an account of the thinking that intersex people came up with themselves, and also the thinking that intersex people immediately came into contact with. The latter was in large part being done by feminist scholars, who were bringing both the science of sex and the process of assignment (and the harm they entailed, in practice) into broader view. That also makes it a book about the interplay of intersex liberation efforts in their autonomous form, and feminist attempts to integrate intersex experiences into their own understanding of sex as a process.

AS: One of the key ideas in the book is that sex is ‘expressive.’ That’s a striking phrase, but maybe not immediately intuitive. Could you unpack what you mean by that in simple terms? How does that way of thinking challenge more familiar ideas, like standard distinctions between sex and gender?

JG: Sex being expressive is sort of a triple entendre, if you will. First of all, the intersex movement appears at the end of the 20th century. All through that century, there were efforts to understand sex in new hormonal terms: as the rising and descending tides of ‘inner secretions’ which make up a whole host of things about our body. And I mean everything: from insulin directing blood sugar to estrogens building up our muscles and bones!

This biological term, expressiveness, was often used as the counterpart to genetics. There’s our genetic coding and then our phenotype (as biologists would call it, or philosophers: appearance)—together, that’s the expression. Regulation of our hormones could be manipulated increasingly easily, as these ‘building block’ chemicals (steroids or lipids) could be isolated and then extracted industrially from plants. Birth control, bodybuilder steroids, Melatonin as a sleep supplement, or medication for diabetics are only the best known examples (today there are many). So the first, technical meaning is that sex is a phenotypic expression of genetic coding.

Secondly, there’s also a sense in which sex is relied upon to be fixed and constant. When discussing the terms sex and gender, people want gender to be the wobbly, fluid, variable, adjustable element and sex to be the fixed, reliable, steady, solid element—sort of like a cliff face beneath the waves or something like that. That’s a split I want this book to upset!

In the 1990s, this distinction began to be challenged by feminist cultural theorists. The most famous of them is Judith Butler, whom I interviewed rather notoriously back in 2021 about their notion of performativity. The way that I see it, performativity goes half as far as I’d like to go. It provides a very convincing and cogent account of gender. But I think it also leaves outstanding a need to actually address sex itself.

If neither gender nor sex is self-expressive (as Butler argued back in the 90s), what does sex express?

AS: A million dollar question! And what about the third meaning? Throughout the book you repeat that ‘Sex is expressive…but not self-expressive!’ So whose will does get expressed through it?

JG: This third meaning is what the feminist theorists and the intersex movement began to realise when they started to scrutinize and challenge medical conventions around the treatment of intersex people. They realised that some very crude and rudimentary understandings of human bodies, human sexuality, even human marriages were being imposed upon the infants and children who are identified as intersex. Specifically, doctors would fantasize what a marriage might look like for someone with a particular set of genitals, or what kind of teasing or bullying they might encounter in locker rooms. And all of these anxieties on the part of medical professionals were being transposed (and then actually imposed…) onto intersex people. So in many cases, intersex variations, which very often didn’t seem to provide any acute source of medical emergency (or even clear cause for concern…), were being blown up into a larger set of problems, which would require experimental surgical ‘remedies.’ (And then further fixes following from those ‘fixes’…)

The book explores a whole bunch of different variations, from so-called mild ones like hypospadiasis (urethral openings along the underside of the shaft—classed as ‘unambiguously male’ by doctors) to cases where a final statement on someone’s sex was often seen as required by a medical professional (such as some cases of Congenital Adrenal Hyperplasia). And also how some intersex cases were switched from being considered ‘male’ to ‘female’ as technology advanced (with XXY and XO genetics trading places—twice!—over a few decades). So across one lifetime, a single intersex person could be ‘declared’ three differing true sexes! Then finally not to be intersex at all, but simply suffering from a Disorder (the new term-of-art from the early 21st century, clinically speaking). From this historical view, sex starts to look anything but fixed…

AS: What happened to people in that situation?

JG: They might not have even noticed! They certainly were not told, at the time. But harms done to intersex people are not just some idealist fussing over categorisation. Intersex anatomies (and physiologies) came to be seen not as part of the full beauty of human diversity at all, but instead as a problem to be corrected: through scientific management by their doctors.

Along the way, the fantasy speculations of these physicians, which would become known as ‘heterosexist’ views among feminist theorists, were being applied to intersex people, to stabilize sex (or as they put it: to ‘manage’ it). In this third meaning, expressive is not a hopeful or optimistic outlook on sex. It’s that our bodies get overwritten or rewritten by people around us. They often express whims and edicts from authoritative figures, like doctors, priests, judges, or people writing medical textbooks, who each provide their own kind of scripts that narrow our sense of the lives we could hope to live. And overwrite our potential lives with their narrow anxieties, and restrictive phobias.

That leaves a lot of harm for us to undo!

AS: This third meaning of ‘expressiveness’ shows that sex isn’t just about bodies or identities, but also about institutions. What role does the state play in defining sex?

JG: The state has expectations that it places on people in terms of their sex (and especially their parents…). Any child that is born would normally have a birth certificate that requires them to be declared male or female, with various life-long ramifications for the different institutions they encounter later on in their life. In Britain, this is now a very pressing, emergency issue for a lot of people (with unclear appeals to ‘biological’ sex by jurists apparently disregarding much of the complexity the intersex movement has previously brought to light). In the 20th century, this was used as a pretext to push surgeries.

That’s part of a long legacy of intersex concerns being disregarded during broader trends (within feminism and beyond). Notably, the intersex movement was emerging in exactly the same decades that Western states were prohibiting various procedures around female genital mutilation (FGM) or female genital cutting (FGC). So the early intersex movement identified an unmistakable mismatch in the protections that were being afforded to those with more conventional-looking genitals versus intersex people—an obvious injustice! 
In many cases, there would be explicit dispensations for doctors who would be performing the same procedures covered by FGM legislation, when they operated in the context removing gonads from people who are born with XY genetics while seemingly female (due to Androgen Insensitivity), or removing clitoral tissue to reduce what they called an ambiguity in terms of genital tissue. These exemptions were both something that existed on the level of legislation, but they also existed in the terms of what feminist movements were actually campaigning for. Adding insult to injury (quite literally…) a wildly popular feminist play of that era—The Vagina Monologues—even featured an Androgen Insensitivity operation on a Midwestern child, played for laughs. So it was a case of being excluded both from state protection, and also from the mainstream of feminist discussion and agitation.

AS: And how does that same picture look today?

JG: Much improved, much left to do!

Later in the book, I look at successful efforts across the ‘margins of Europe’: Greece, Malta, Portugal. I introduce the Intersex Justice Project, which enjoyed local wins across the US through an intersectional and anti-racist approach to intersex struggles. I also explore 21st century Germany, where the introduction of a new X-sex passport (ostensibly a progressive measure, promoting intersex rights!) ended up used in the same way…Pressure for parents to agree to experimental surgeries, without any true therapeutic basis. Yet equally both Germany and the US  are case studies for a troubling new development: powerful rights groups emerging focused not on intersex people, but their parents! These groups usually adore the framing of Disorders: these are not human rights struggles, but rather unfortunate parents locked into ‘managing’ a rare disease (or so these family-oriented groups will tell you…)

I will say that a lot of intersex politics is now done at the level, not of the local nation-state, but of global governance bodies. So: the Council of Europe, the EU Basic Rights Committee, the African Commission on Human and People’s Rights, and the UN special committees for topics like Torture or the Rights of the Child. A lot of agitation looks not at any particular government or state, because it’s quite hard to actually make breakthroughs on that level! With some welcome exceptions like Greece, the political climate for enshrining sex complexity is becoming bleak. With right-wing regimes in places like the US or Russia, more explicit exemptions of intersex are now being enshrined in law.

At the supranational level, it’s felt that expertise is more easily questioned and sympathetic voices can be more easily found. International organising also allows larger community meetings, of several hundred intersex people from across an entire continent! So what was once an edgy movement has been reframed as the protection of intersex human rights, to be won both locally, and worldwide.

AS: Your book also foregrounds race in a really important way. How does racialisation intersect with intersex politics and the policing of sex? Do you see contemporary debates (especially around sport or public visibility) as continuing older colonial logics?

JG: Recent discussions around sports have definitely pulled on legacies of racialized understandings of hermaphroditism! Since the 2000s, intersex topics have often been understood through controversies about athleticism and competitive sports. At the global governance level, there are lots of disagreements over who should get to compete as which sex. Two specific flash cases were Caster Semenya, a champion track runner from South Africa, then more recently Imane Khelif, an Olympic boxer. In both cases, the controversy was inflamed by images of weeping white competitors who they had defeated. Khelif especially was used by Donald Trump, among others, to whip up a frenzy about whether a woman believed to be intersex should compete as one. 

These women became a really awful cause célèbre for understandings of intersex physiology more generally. There are two things to say about that. The first is that by the late 2000s, the medical understanding of intersex had really shifted towards a disorder, which doubled down on pathologizing views of intersex variation. Of course, these athletes didn’t really fit easily into this shift, given that their disorder was supposedly giving them such a tremendous advantage on the international stage of competitive sports.

The second legacy is that these controversies drew on an extensive history of racist science. In South Africa, especially, all through the 20th century (before Caster Semenya was even born) there was an attempt to understand black South Africans by Apartheid-era white doctors as prone to what was called ‘true hermaphroditism,’ that is, having mixed gonadal tissues from different sexes. There were multiple, entirely spurious studies, specifically based around the bantustans, that were trying to demonstrate that black South Africans were prone to hermaphroditism. Obviously, a very convenient conclusion for any white Apartheid-era researchers favouring that country’s racial order! This is the kind of legacy that people in the most strife opposition to Caster Semenya and Imane Khelif were pulling from, even if they themselves didn’t realize it.

The simpler answer to your question is just that figures like J.K. Rowling or Donald Trump seize upon these stories because they provide a shortcut. They can post images or video clips and say that no argumentation is needed. Sex is that obvious! Anyone can look at these images (they promise) and see sex for themselves. There is a simplicity to that toxic brew: interphobia, sexism, and racism. It allows for a kind of straightforwardness (arguing without having to even argue…) which right-wing commentators or even elected politicians really relish playing off.

So our task is making the case for sex’s complexity equally compelling!

AS: Readers will know your earlier work on family abolition and trans Marxism. Has writing about intersex struggle changed how you understand family and social reproduction more broadly?

JG: In my research for this topic, families appeared very differently depending on what I was reading, whether it was medical expert documents or the in-house discussions of intersex that you would read among clinicians, parents, and families. Many of those discussions are about the fine-grained management of intersex variation, or as they would say, the condition or the disorder. One might even call this the grooming of parents by clinicians. In some cases, that included the delivery of specific scripts for how to brief extended family on parents having had an intersex child. 

In intersex writings, on the other hand, the story is a bit more tangled. Often, really detailed accounts of families appear. The first chapter of intersex memoirs will often be much more about the introduction of a family than of the intersex person themself. This is reflective of how the medical procedures and upbringings of intersex people follow from the prejudices, sensibilities, and particularities of their families.

The intersex movement is both struggling against the norms of clinical care and coming to terms with the harms that have been authorized, ordered, or endorsed by direct relatives. Or at the very least, the neglect, concealment, reframing, and euphemisms that the relatives delivering concealment-as-care have given them. Intersex liberation is about overcoming the existing harms done and preventing future generations of intersex people from having to face both the complex of harms which have been administered in medical contexts, and also the abuses and neglect which they’ve experienced from their actual families.

I should say that often, family members have been at the forefront of these intersex struggles. I signed one copy of the book at one of my first readings at a feminist bookstore to both a mother and her intersex kid, so I am meeting parents and intersex relatives. And community events run by intersex people often have children with their parents present as allies. This is a living part of the movement’s make-up, and it’s very beautiful and encouraging. I think one of the ways forward is about allowing parents who are raising intersex children to have a dialogue and involvement with people who’ve been living with intersex variations for all of our lives.

AS: Finally, what other historical struggles was intersex liberation connected to? And looking forward, what kinds of political struggles do you think intersex organising might help to inspire?

JG: The movement developed, first and foremost, in an interplay with feminist understandings of sex. But equally, there was a high level of involvement from trans militants, to the point that there were more trans members of the local group (Boston Menace) than out intersex people at the first demonstration in Boston in ’96. Taking to the streets ain’t easy! The interconnection between the trans and intersex movements was profound and included pioneering trans thinkers, such as Susan Stryker and David Valentine. Without this support offered freely from early trans allies (from sound tech, to picketing 101), it’s hard to picture the impact so few out intersex people were able to have. Quality over quantity!

If we look more generally at LGBT involvement, there were gay and lesbian magazines that would host special issues or allow the intersex movement to use their personal pages to recruit members. A lot of the hubs of LGBT culture in the late 20th century, especially in the Bay Area, map onto the development of intersex activity. There was a tremendous amount of support, which was both underground and institutional, with groups like the American Association of Gay & Lesbian Physicians supporting this cause from 1996.  These very early, deep connections are quite key to understanding the movement. In the book, I call the intersex movement born from wise Hermes (feminist theory) and beautiful Aphrodite (gay street struggle).

As for the way forward, it’s inevitable that we have a deeper level of interconnected involvement—exactly because the campaign to worsen the mistreatment of intersex people and to drive trans people out of public life is one and the same thing. We see this especially in US red states, where the same pieces of legislation that outlaw transition for teenagers also have explicit exemptions for intersex surgeries. That is: they state outright that the definition of mutilation in these new legislations doesn’t extend to the protection of intersex children! Similarly, in Russia, chemical transition was banned as part of the war effort through the same kind of legislation, which again featured explicit exemptions for the harms routinely done to intersex people by doctors.

In each of these instances, we see that the global right makes no real distinction between trans and intersex people, as it moves against both. So whether we want to take an intersectional approach, or another kind of coalition, is by the by—the right isn’t struggling with making a distinction between trans and intersex people. Their foe is gender ideology, and anyone who seems to embody that. So while the Marxist left often finds questions of gender (and worse: identity) confusing, the right has a straightforward and ruthless vision around the sex question. This has become a conversation they’ve really started to dominate.

So in that desperate context, this book demonstrates the urgency of forging new alliances and new lines of solidarity on the left. My message is heartening, against all the odds. Start with however few you have (two will do!), recognise what exists between you, and then go from there. Don’t be shy about being unusual, don’t deny your complexity. Just a handful of outspoken hermaphrodites can change everything. After all, that’s the only way we came to recognise ourselves, in the first place!

Juliana is the author of Hermaphrodite Logic: A History of Intersex Liberation, published by Verso Books. Alex is the author of Eros and Empire, published by Stanford University Press.