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U.S. Rollbacks on Intersex Rights Risk Setting a Bad Precedent Globally
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Commentary
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Publish Date
January 5, 2026
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When U.S. states pass laws banning gender-affirming care for transgender youth, they often claim they are acting to protect children. But as an intersex human rights advocate, I know that buried within many of these laws is a reality lawmakers rarely acknowledge: these policies continue to permit irreversible harm to intersex children. Harm that intersex people in the United States and around the world have been speaking out against for decades.
Each of the twenty-eight state laws banning gender-affirming care for trans youth includes what are commonly referred to as “intersex exceptions”. These carve-outs allow doctors to perform medically unnecessary and irreversible surgeries on infants and young children born with variations in sex characteristics. These harmful practices were largely developed in the U.S. more than fifty years ago and exported around the world.
As intersex advocates and international human rights bodies have documented, politicians and medical professionals who defend these interventions do so not on the basis that they address urgent health needs, but by evoking social pressure to make bodies conform to rigid ideas of female and male. In the new wave of laws, the intersex exceptions are not protections. They are permissions to continue harmful medical practices that intersex adults across cultures, countries, and generations have consistently described as human rights violations and intersex genital mutilation.
What makes this moment especially dangerous is the contradiction at the heart of these laws. Transgender adolescents who can articulate who they are, who participate in medical decision-making with families and clinicians, and whose care is supported by major medical associations, are denied treatment. Intersex infants, who cannot speak or object, remain legally subject to irreversible interventions intended to enforce social norms about sex and gender.
Lawmakers claim they are preventing irreversible harm. Yet they explicitly allow irreversible harm to continue – so long as the child is intersex.
The U.S. Lags Behind – And Risks Exporting Harm
This contradiction becomes even more troubling when viewed in a global context.
Around the world, intersex-led organizations and human rights bodies are increasingly calling for an end to non-consensual, medically unnecessary interventions on intersex children. International human rights bodies, including multiple UN treaty committees and Special Rapporteurs, have called on governments to end non-consensual, medically unnecessary interventions on intersex children, identifying them as violations of the rights to bodily integrity and freedom from ill-treatment. Just last year, the UN Human Rights Council passed the first-ever resolution to protect the rights of intersex people, followed this year by a groundbreaking report by the UN Office of the High Commissioner recommending an end to these practices.
Countries such as Malta, Spain, Germany, Iceland, Portugal, and Greece have enacted laws or binding standards that restrict or prohibit these practices unless there is an urgent health need or meaningful consent. Recently, the Council of Europe adopted landmark recommendations, including prohibiting non-consensual medical interventions and ensuring that any medically unnecessary interventions on intersex children are postponed until they can decide for themselves.
Sub-national jurisdictions in Australia and India have taken similar steps. These reforms reflect a growing recognition that intersex bodies are not emergencies, and that children deserve time, honesty, and autonomy.
The United States has taken the opposite approach. Instead of adopting affirmative protections, many states have chosen to preserve these practices quietly, embedding them in laws aimed at transgender healthcare. No U.S. state has enacted comprehensive, enforceable protections that delay non-urgent intersex interventions until the individual can meaningfully participate in the decision.
This divergence matters. The United States has enormous influence over global medical standards, legal reasoning, and policy debates. When U.S. states codify intersex exceptions into law, those provisions rarely remain local. They are likely to be cited by governments, courts, and medical institutions elsewhere as justification for maintaining harmful practices. Outright International and our activist partners have frequently reported that countries opposing progress on protections related to sexual orientation, gender identity and expression, and sex characteristics protections often reference the positions of the United States to back claims that such reforms remain controversial and lack international consensus.
U.S. policy is swimming against the emerging global tide of intersex rights – and the likely negative global impact is looming. Activists should be concerned and prepared to push back. Earlier this year, just days after President Trump issued an executive order defining “sex” in a manner that erases both transgender and intersex people, Kenyan President Ruto publicly supported the decision, despite Kenya being the only country to recognize intersex as a third sex officially!
All Children Deserve Bodily Autonomy.
At their core, these laws establish a hypocritical, discriminatory system that singles out certain bodies – those that meet binary norms – as requiring “protection,” while others are subject to state-sanctioned “correction.” Trans youth are denied care as a result of moral panic around “permanent and irreversible changes” to their bodies, while intersex children are subjected to permanent alterations in the name of “normalization.” This framework tells both intersex and trans people, across borders, that our bodily autonomy is conditional.
Globally, intersex adults have described lifelong consequences of these interventions: physical pain, loss of sexual sensation or fertility, trauma, and deep mistrust of medical systems. These are not theoretical harms. They are documented realities.
This is not a conflict between transgender children and intersex children. It is a question of whether we believe that all children have a right to bodily integrity and self-determination. Protection does not mean forcing irreversible decisions onto infants and children who cannot consent. Protection means allowing people, wherever they are born, to grow into themselves, with support rather than coercion. Intersex people around the world do not need our bodies changed to be safe. We need time. We need honesty. We need our rights respected.
Other governments should be looking outside of the U.S. for inspiration and better ways forward in support of intersex youth. Global activists are well advised to promote the recent landmark reports from both the UN and the Council of Europe and use them as informed guidance in working with national lawmakers.
U.S. policymakers need to prioritize the best interests of every child in a manner that also supports individual autonomy and self-determination. Last year, the government was finally moving in the right direction for the intersex community, as evidenced by a groundbreaking report by the U.S. Department of Health and Human Services acknowledging intersex health inequities and making policy recommendations to prevent harm to intersex children and support their health needs across the lifespan. That was indeed policy guidance worthy of sharing globally – and still is.
Until laws reflect that truth, for intersex children and transgender youth alike, claims of child protection will remain incomplete if not outright hypocritical, and justice will remain out of reach for too many of us.
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