Intersex surgery is a category performed on individuals who have had irregular sexual development and require reconstructive surgery to restore or improve appearance and function of their genitalia. Disorders of sexual development (DSD) can occur as congenital disorders or defects or from early injury to the sex organs. Numerous conditions exist that may require intersex surgery and include chromosomal, gonadal, and phenotypical sex disorders. A surgeon generally performs this type of operation to make a patient look and function more as a typical female or more as a typical male.
The degree of intersex surgery the surgeon performs is based on the severity of the patient's condition. This may consist of a relatively straightforward surgery, such as the cosmetic reconstruction of the vagina. Surgery may also be much more complex, such as assigning a gender to an individual whose gender is ambiguous. If the DSD is identified at birth, the surgeon usually performs the surgery before the patient is 24 months old. Surgery is often supplemented with hormone therapy.
Intersex surgery is performed for a number of reasons. Physically, it can help patients to function more normally in terms of continence, sexuality, and fertility. It can also help the patient socially as it places him or her more firmly in one gender or another and reduces abnormalities that may cause social awkwardness or dysfunction. Surgery is believed to subsequently help both patients and their families from a psychological perspective by enabling them to better conform to cultural norms.
This, however, is also what makes intersex surgery controversial. There are many ethical questions surrounding the surgery and its future implications for the individual. Normally, the patient is treated not only by the surgeon but also by a team of specialists that may include counselors, geneticists, and endocrinologists. This is especially true for patients who are having gender assignment or reassignment surgery.
The ethical questions of performing the surgery on an infant who cannot make a choice about gender and the future physical and psychological implications have prompted much debate about the procedure, especially as some patients feel later in life that their surgeries were inappropriate. Although often performed when the patient is an infant, surgery may also be carried out when a patient is old enough to make an informed decision about his or her own gender. This debate is especially important for those patients for whom the surgery is not medically necessary but rather a social or cultural choice.