The Sunday News
Fortunate Muzarabani
In a world socially constructed of binaries, intersex children struggle with belonging.
A nine-month-old Bulawayo baby is trapped in the eye of a storm as maternal and paternal sides of its family accuse each other of practicing witchcraft.
The child was born with ambiguous genitalia and it is not completely clear if the baby is male or female. Ambiguous genitalia is a rare condition in which an infant’s external genitals don’t appear to be clearly either male or female. In a baby with ambiguous genitalia, the genitals may be incompletely developed or the baby may have characteristics of both sexes.
The paternal side of the family has opted for immediate surgery, while the mother of the child and her family are suggesting that other options be considered.
The child’s mother wants the baby to be allowed to grow up and make a decision on sexuality at least at the age of 18 years. Despite the blame that has been shouldered on her and why and how she could bring “an abomination’’ to the world, she still sticks with protecting her baby.
Fortunately, a local sexual and reproductive health rights organisation, the Sexual Rights Centre, has been engaged on the matter and is now assisting the family negotiate a way forward.
Sexual Rights Centre
Less than 150km away from Bulawayo, in Zimbabwe’s Tsholotsho district in Matabeleland North province, another child was in a similar predicament. However, in this case, the adolescent’s fate has already been sealed. Thembani Ncube is the child, who is always casting a lonely figure at the school grounds during play time.
Struggling with identity and belonging, life in the village has not been rosy. It never crossed the mind of others why Thembani never used the school toilets back in Sipepa Village, in the company of other learners.
When turning eight, Thembani first discovered the difference to others. Life became more uncomfortable as an increasing number of people outside the family became aware of the condition. The whole village was curious.
Since birth, Thembani was raised as a girl. In 2019, at 13, community members as well as the media came together and a fundraising for an operation was done. Doctors recommended that she maintains the female gender, after tests were conducted.
After surgery, she was happy that although there were still some differences, she looked more like other girls. Finally, she belonged, so she thought.
However, her joy was short-lived as puberty kicked in. She started developing a lot of facial hair, her voice was cracking and suddenly it developed a more masculine tone.
All this was more confusing. The breasts did not develop, instead she got broader shoulders and a more masculine physic.
More trips had to be made to doctors, and the solution was that she has to take hormonal medication until her puberty stage is complete. Right now, slightly older at 15 years, but still a child, Thembani would have wanted to have a say on the process and says this confusion has made for a lonely life.
The mother is however, happy that her child now has a proper gender on a birth certificate.
“My life was rough, having to raise a child whose nappy I could never change in public. I always bathed her indoors and no matter how nice relatives were, when they offered to change her diapers or bathe my child, I would never allow them. But at some point some close relatives, whom we had let in on our family secret told other people, and we had to do something. There is no n’anga (traditional healer) we did not visit or local prophet we did not consult. I am happy for my child now,” said Mrs Soneni Ncube, Thembani’s mother.
The actual number of children in similar situations in the country is unknown. However, global statistics estimate that approximately one in a thousand people is born intersex.
While there is growing understanding and embracing of people with ambiguous genitalia, it is only one variation of intersex, as there are more than 46 variations of how being intersex can manifest.
Other intersex manifestations may not show on genitals, but may be hormonal and genetic. Faced with stigma, ignorance and outright prejudice, intersex persons have been at the receiving end in most societies.
The usual response by medical practitioners is often to carry out largely controversial and not fully regulated surgeries that aim to make a child’s genitals and reproductive organs appear more normal. However, these often result in unintended consequences, according to intersex adults, advocates and some doctors.
A long and spine-chilling list of damaging side effects including but not limited to painful scarring, reduced sexual sensitivity, torn genital tissue, removal of natural hormones and possible sterilisation, combined with a significant chance of assigning children a gender they don’t feel comfortable with, has left many calling for the surgeries to be heavily restricted.
Zimbabwe is one of the countries that have started the journey of restricting such surgeries which have been labelled as highly invasive, however, some families are still taking their children outside the country or to local surgeons for such procedures.
Speaking to this publication, Zimbabwe Human Rights Commission (ZHRC) deputy chairperson, Dorothy Moyo, said working with various Government bodies and some civil societies organisations, stakeholders had come up with a framework that seeks to protect all intersex children. This has led to a ban on genital normalising surgeries for minors.
Moyo said one of ZHRC’s mandate is to ensure that the rights of all persons in the country are respected, including minorities. She said the ban on surgeries for all children under the age of 18, was a step forward in ensuring that intersex persons were accommodated and protected within the country’s statutes.
She said the commission has been working on the issue for a number of years, adding a Government gazette had been released, on the outlawing of the genital correcting surgeries.
“We did input into these decisions. We did cover the issues of the genital normalising surgeries during our national inquiry. We found out that when that child is born, the parents of the child decide if it is a boy or a girl. When the child reaches puberty, and the parents had decided it was a girl, but if it later turns out that the child is more of a boy, it becomes very difficult to now change the birth certificate of that child. The child suffers a lot of stigma, the birth certificate will say it is a boy, when it is actually girl. This leads to more stigmatisation and lack of opportunities in such a situation,” said Moyo.
She said the commission was carrying out work to eliminate stigma and create more awareness on intersex persons, particularly in rural communities. Communities are being taught that the condition occurs naturally, with the hope that more families will be comfortable with their children identifying as who they actually are.
Moyo said the ZHRC was also engaging the registry department to come up with progressive policy work that is going to be more inclusive of Zimbabweans in their diversity.
Intersex persons in the country are formalising their movement and taking up the fight to communities to create more awareness about their existence.
Intersex Community of Zimbabwe founder (IcoZ) Rony Nyasha Zuze said they had a difficult childhood growing up, and had to endure two surgeries to “correct” their ambiguous genitalia condition.
Rony says to date, the scars of the surgeries are a reminder of what should not have been done. They feel robbed of the opportunity to determine their sexuality, and said someone else made decisions on their behalf, of a very personal nature.
“I was born intersex, of ambiguous genitalia, which means that I do have sex characteristics of both male and female. Intersex people come in more than 46 variations but ambiguous genitalia is the most common. I only discovered about being intersex in the early stages of my childhood. It used to confuse me and torment and I always wondered why I was different from the others. As I used bathrooms at school, I would make sure that I was by myself. If I had to use it with other kids, I always used the sitter cubicles and never the urinals,” Rony said.
“Later as I was all grown up, other features started showing up, and my parents started raising me as a girl, the whole time I had been brought up as a boy.”
They said they suffered mental health breakdowns due to the confusing stages growing up. Rony said they most had to undergo two surgeries at different stages of their life.
He said they founded IcoZ to create awareness and reach out to more people like them, and to ensure that no more child experiences the amount of pain and discrimination that they encountered.
“I had to undergo two surgeries. I still have scars from those, and I have suffered health complications because of those surgeries, however, my parents were told that it was going to make me normal. It was not necessary. Intersex people are not legally recognised by the Constitution of Zimbabwe. It then becomes difficult to fight for our rights, our identity documentation does not even provide for us, it does not acknowledge our existence. Intersex people are facing a lot of discrimination yet they never chose to be born intersex,” they said.
Rony’s work now evolves around creating awareness and making efforts to ensure that no more child in the country will have to ensure the childhood experiences that they went through.
Most parents are disturbed by the appearance of the genitalia and request that something be done as soon as possible so that their baby “looks normal”.
Mpilo Central Hospital started a registry of intersex persons in the region in 2019, which attracted people from as far as Harare, Zambia and Malawi, who expressed interest in corrective surgeries. however, the actual number of intersex persons in the country is not known, mostly due to stigma and little to no research done on the community.
Specialist gynaecologist and Clinical Director, Professor Solwayo Ngwenya was leading the project. Speaking to this publication last week, Professor Ngwenya said due to Covid-19 related disruptions and onslaughts from sexual rights activists, his project suffered setbacks but said work was still on course.
“Indeed, we suffered quite a few setbacks with the pandemic coming in almost at the same time as when this project to have a registry for intersex persons started. We have about 50 people who have come forward and expressed interest to get help with their conditions and soon, hopefully they will get that help. Some came from as far as Zambia, Malawi and other regions in the country. Most of these conditions can be corrected and they may lead to potential health complications, including cancer, if left untreated and they also lead to a lot of confusion for the person, which also leads to psychological trauma and mental health issues,” he said.
Sexual Rights Centre programmes officer, Mojalefa Mokoele said the SRC has helped some families reconsider decisions to have very early surgeries done on their children, with the view of helping them make their own choices as adults.
“As a sexual and reproductive health rights advocacy organisation, we believe in bodily autonomy and we are saying that intersex children should be allowed to grow up and make decisions on their sexuality. All these unnecessary surgeries should not happen, unless if it is done for genuine health reasons to help a child pass urine or for other biologically necessary processes. However, we have called for an end to the genital normalising surgeries as they are a form of genital mutilation,” he said.
The United Nations Human Rights Office in its 2015 United Nations Free and Equal campaign, released the first fact-sheet on the rights of intersex persons. The campaign exposed how intersex children and adults are often stigmatised and subjected to multiple human rights violations, including violations of their rights to be free from stereotype and ill-treatment, to health and physical integrity as well as equality and non-discrimination.
Some studies estimate that Zimbabwe may have about 160 000 intersex persons (1 percent of 16 million), calculated using the average global intersex population which stands at between 0,5 per cent and 1,7 percent of the global population.
*This feature was written with support from the Voluntary Media Council under a project aimed at unravelling issues affecting the minority groups.
