{"id":105154,"date":"2025-04-01T18:55:05","date_gmt":"2025-04-01T23:55:05","guid":{"rendered":"https:\/\/news.medill.northwestern.edu\/chicago\/?p=105154"},"modified":"2026-01-01T16:05:49","modified_gmt":"2026-01-01T22:05:49","slug":"anti-transgender-executive-orders-threaten-intersex-people","status":"publish","type":"post","link":"https:\/\/news.medill.northwestern.edu\/chicago\/anti-transgender-executive-orders-threaten-intersex-people\/","title":{"rendered":"Anti-transgender executive orders threaten intersex people"},"content":{"rendered":"

By Fern Alling
\n<\/strong>Medill Reports<\/em><\/p>\n

In the first two weeks of his second term, President Donald Trump signed eight executive orders that explicitly targeted transgender Americans. Some resulting actions \u2013 like restrictions on gender-affirming care for people younger than 19 years old \u2013 were temporarily blocked by federal judges. Others \u2013 like changes to passport markers \u2013 are still in effect.<\/p>\n

These orders pose evident harm to the transgender community. But another group threatened by Trump\u2019s actions is receiving less attention, advocates say.<\/p>\n

\u201cIt\u2019s not something that I can just stop talking about and it goes away,\u201d said Nessa, a visual artist based in Maryland. \u201cBeing socially identifiable as someone who\u2019s different in a way that politics don\u2019t like right now is a little scary.\u201d<\/p>\n

Nessa, who asked to be identified only by her first name for safety reasons, is one of the estimated 5.7 million Americans who are intersex, not readily categorized as biologically male or female. Anti-transgender legislation like the recent executive orders threatens the health and well-being of the intersex as well as the transgender community, experts say.<\/p>\n

 <\/p>\n

Binary sex definitions could deny aid programs for intersex Americans<\/strong><\/p>\n

One of the anti-transgender executive orders describes two sexes the federal government will recognize: male and female. \u201cMale\u201d refers to \u201ca person belonging, at conception, to the sex that produces the small reproductive cell,\u201d while \u201cfemale\u201d refers to \u201ca person belonging, at conception, to the sex that produces the large reproductive cell.\u201d These sexes, according to the order, are \u201cgrounded in fundamental and incontrovertible reality.\u201d<\/p>\n

Maddie Moran, communications director of intersex advocacy group InterACT, said these definitions raise questions for intersex Americans.<\/p>\n

\u201cThere are intersex people who have ovotestes, where they might produce both types of reproductive cells,\u201d they said. \u201cWho are they under this executive order? Do they count as male or female? There are people who have no gonads. Where do they fit under it?\u201d<\/p>\n

Definitions of demographic categories like sex inform the way the government determines eligibility for certain aid programs, like those for young mothers. Nessa said some intersex people she knows are worried they won\u2019t qualify for assistance anymore under the executive orders.<\/p>\n

\u201cIf we legally don\u2019t exist, that means they can just ignore us when it\u2019s convenient,\u201d she said.<\/p>\n

 <\/p>\n

What is intersex?<\/strong><\/p>\n

The term \u201cintersex\u201d is a blanket term for dozens of naturally occurring variations in human sex characteristics that can blur the lines between male and female. Intersex variations can relate to hormones, chromosomes, reproductive anatomy or some combination of the three. These variations are present at birth and do not develop over time.<\/p>\n

It\u2019s hard to keep count of the intersex population. Hospitals aren\u2019t required to track how many intersex children are born. Even if they were, intersex traits may not become apparent until puberty, if at all.<\/p>\n

Most advocacy groups, government organizations and medical organizations put the number of intersex people at 1.7% of the world population. But, Nessa said, that doesn\u2019t mean intersex people are rare.<\/p>\n

\u201cThat\u2019s one person in a small high school graduating class. That\u2019s a few people in the shopping mall at any given time,\u201d she said.<\/p>\n

 <\/p>\n

\"\"<\/p>\n

 <\/p>\n

Intersex and transgender experiences are different, but related<\/strong>\u00a0<\/strong><\/p>\n

There is notable overlap between the transgender and intersex communities. A 2024 report by The Trevor Project found 75% of the intersex youth surveyed also identified as transgender. At the same time, the two are not synonymous.<\/p>\n

\u201cTrans identity is a sense of self, like, \u2018This is who I am. This is how I want to be in society. This is how I want society to receive me,\u2019\u201d said Sean Saifa Wall, an intersex advocate and co-founder of the Intersex Justice Project. \u201cIntersex is biology. It\u2019s literally the nuts and bolts, the tissue, the organs.\u201d<\/p>\n

Only one anti-transgender executive order, \u201cDefending women from gender ideology extremism and restoring biological truth to the federal government,\u201d contains the word \u201cintersex.\u201d But that doesn\u2019t mean the rest of the orders won\u2019t impact the community.<\/p>\n

\u201cAlmost every single anti-trans bill targeted at trans individuals does negatively affect intersex people, whether or not that\u2019s the intended target of the bill,\u201d Moran said.<\/p>\n

State bills are publicly debated and voted on, unlike executive orders, which only need to be signed by the president to take effect.<\/p>\n

 <\/p>\n

\"Transgender<\/p>\n

 <\/p>\n

Removing intersex people from government research exacerbates an existing knowledge gap<\/strong><\/p>\n

The intersex population was largely ignored by the federal government until recently. The Department of Health and Human Services released the first federal report on intersex health, \u201cAdvancing Health Equity for Intersex Individuals,\u201d on Jan. 16. Its findings: 47.8% of intersex people surveyed delayed getting emergency health care, and 65.4% delayed getting preventative health care because of negative medical experiences in the past.<\/p>\n

The report called for greater civil protections for intersex people, government research into policies that can improve intersex health and more data collection on intersex individuals. It was removed from the Health and Human Services website after the Trump administration took over, about a week after its release.<\/p>\n

 <\/p>\n

Anti-transgender legislation doesn\u2019t prevent intersex youth surgeries<\/strong><\/p>\n

Dr. Ilene Wong, a urologist who frequently sees intersex patients who underwent surgery as minors, said the removal was \u201chorrifying.\u201d Wong said it\u2019s common practice for doctors to perform so-called cosmetic surgeries on intersex infants and youth to make their genitals appear more typically male or female.<\/p>\n

While surgery is necessary in some life-threatening instances, intersex advocates and health groups like the American Academy of Family Physicians and the American Academy of Pediatrics argue nonessential surgeries should be delayed until the intersex patient can make an informed decision.<\/p>\n

Wong\u2019s first exposure to the cost of improper intersex care happened when she was a resident. She said she participated in a surgery to remove gonads from a young woman with androgen insensitivity syndrome. Only once the surgery was complete did she realize the patient wasn\u2019t aware of the consequences.<\/p>\n

\u201cNo one had really consented this girl properly. She had no idea she would need to be on hormones, likely that she would be set up for osteoporosis,\u201d Wong said. \u201cShe was essentially menopausal, and she was 17 years old.\u201d<\/p>\n

The fifth executive order targeting transgender people describes gender-affirming care as \u201cchemical and surgical mutilation.\u201d Alithia Zamantakis, a research assistant professor at Northwestern University\u2019s Institute for Sexual and Gender Minority Health, said nonconsensual surgeries on intersex youth are more akin to mutilation than the elective surgeries some transgender youth undergo.<\/p>\n

\u201cIntersex surgeries cause lifelong harm to a child. Gender-affirming care has lifelong benefits,\u201d she said. \u201cAnd yet we ban gender-affirming care and promote intersex surgeries.\u201d<\/p>\n

Legislation outlawing gender-affirming care for minors in at least three states \u2013 Georgia, Kentucky and South Carolina \u2013 contains explicit exceptions for surgeries on intersex youth. There is no language exempting intersex surgeries from gender-affirming care in the executive order. However, according to Moran, intersex surgeries are still legal in the U.S.<\/p>\n

\u00a0<\/strong><\/p>\n

The trans panic deputizes body police<\/strong><\/p>\n

Impacts of anti-transgender legislation aren\u2019t limited to the hospital or the courtroom. Increased attention to people who don\u2019t fit gender norms means higher scrutiny of their bodies.<\/p>\n

The Salt Lake Tribune published a story about a Utah high schooler whose sex was investigated without her knowledge. She soundly beat other female athletes at a competition, and their parents complained to the Utah High School Activities Association. The organization determined she was not transgender after reviewing records going back to kindergarten.<\/p>\n

Nessa was told she couldn\u2019t use the women\u2019s bathroom and was directed to the men\u2019s bathroom instead.<\/p>\n

\u201cIt\u2019s not just a thing of, keep your head down and you\u2019re fine,\u201d she said. \u201cIt\u2019s being told you don\u2019t qualify for things and being made to do invasive stuff to prove that you are who you assert yourself to be.\u201d<\/p>\n

\u00a0<\/strong><\/p>\n

What\u2019s next for intersex advocacy groups?<\/strong><\/p>\n

Human and LGBTQ+ rights groups including the ACLU and Lambda Legal are pursuing various lawsuits against the anti-transgender executive orders. Moran said they think the orders\u2019 reliance on unscientific conclusions could be advantageous in a legal setting.<\/p>\n

\u201cThese are unenforceable at the end of the day, so there’s even more grounds to fight it,\u201d they said.<\/p>\n

In the meantime, intersex Americans will be anxiously waiting.<\/p>\n

\u201cIn some cases, the medical care that someone receives, trans or intersex, is a matter of life or death,\u201d Nessa said. \u201cFor a lot of us in both communities, that\u2019s a concern, that our bodies will suffer because of this legislation.\u201d<\/p>\n

 <\/p>\n

Fern Alling is a graduate student at Medill specializing in health, environment and science reporting. You can connect with them on <\/em>LinkedIn.<\/em><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

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