Breaking the Ice

Credit by @Ben Gage

On the last weekend of June, various pride parades are held in many cities in the United States. In this publication, written in 2016 (and edited in 2022) for the international project “Intersex Day”, I want to remind all of us about intersex people and their complicated history of fighting for intersex and LGBTQI in Soviet Russia. In particular, their struggle is reminiscent of what is happening in the modern United States with their turn to radical right-wing conservative values, the power of an authoritarian society over the body and intimacy of a person and a citizen.

Breaking the Ice

Aleksander Berezkin

The first evidence of intersex people in Russia is found in the 18th century, with greater church interest than state interest. In the 19th century, the state began to get involved, including in a case of the "double sex" of a peasant baby in the documents of the Office of the Third Department of His Imperial Majesty in 1837. Local doctors and the authorities were ordered to monitor the child's health and ensure the "holistic conservation" of the child's body during death. From the second half of the 19th century, cases of intersex are increasingly recorded in scientific and medical periodicals. Still, royal power inhibited medical control over intersex bodies compared with Western society at that time [1].

After the 1917 revolution, medical experts secured relative independence from the government, and the situation of intersex people began to change. The new government sought to ensure the "development of the productivity of the working class" by the Marxist ideology. In 1926 the Soviet People's Commissariat of Internal Affairs issued a decree prescribing regulations for citizens "with the characteristics of hermaphroditism" who sought to change their name and gender. Local medical institutions had to confirm a dominant gender. Several dozen cases were examined in the first decade. Of 36 people, 27 made appeals, with 4 identified by authorities during military medical examinations [2]. The historian Irina Roldugina suggests that these data show a desire by the identified intersex individuals to take advantage of medical capabilities: most had surgical operations, some received hormone therapy, and some received psychiatric help [3].

By the mid-1930s, public conceptions of family and sexuality began to change [4]. The state, represented by the Communist Party, began to pay close attention to the development and education of a new type of Soviet man, demarcating the limits of his intimacy and restricting bodies and behavior to meet patriarchal, heteronormative norms. As an expression of human individuality and variability, intersex people no longer fit into the new Soviet collective order. Intersex people were marginalized and stigmatized and even became a taboo subject for discussion in specialist medical journals.

Between 1958 and 1991, intersex cases again became attractive to Soviet clinicians. The Institute of Experimental Endocrinology and Hormone Chemistry of the Academy of Medical Sciences of the USSR began to conduct long-term observations of intersex people, including surgical interventions and the development of hormone therapy and psychosexual adjustment protocols [5]. Changes to the legislation accompanied these on “correction of surname, name and patronymic name in connection with a change of gender (for hermaphrodites)”[6]. The scientific and medical debate began to question the appropriateness of surgery. “Conservatives” believed that “any kind of surgery for hermaphrodites was considered unnecessary.” In contrast, “innovators” thought that successful “surgery, and creating or deleting certain organs” gave moral, domestic, and social satisfaction to the patient and the surgeon; the individual results of operations confirmed their fundamental necessity [7]. This “innovative” view became dominant in Soviet and then post-Soviet medicine.

After 1991, each of the former republics of the USSR began to implement its own legislative and medical programs to treat intersex people. Intersex people in Russia are usually described as people with “disorders of sex development ”[8]. Current clinical debates focus on issues related to defining “sex” and “the importance of early childhood education” about sex, sexuality, and gender “because people cannot live in society without gender. It is almost impossible”[9].

There are now legislated federal standards of care for intersex people in Russia. These describe clinical procedures that are free for children under 18 and regulations assigning different grades of disability. In 2001, federal law on bioethics was drafted, proposing a requirement for written consent by parents or guardians in cases of “gender correction” in “children up to 16 years”[10]. The draft law was rejected by the State Duma (parliament) [11].

Thus, there is a solid ideological connection between the image of the body and the state's vision. Through a system of laws, media, education, national ideas, social practices, and identity, the state defines the boundaries of what is "permitted" and "normal." Authoritarian rule rigidly controls diversity: it must be ordered, recorded, and made to conform to the standard. Any attempt to change elements in such a system beyond what is permissible without agreement from above looks like a protest against the whole system so that social change can progress only through explicit or implicit agreement from the authorities.

Doctors have particular importance in such a system. They are not only authorities but also representatives of the state in matters under their jurisdiction. On the one hand, they are driven by a desire to help people with their physiological problems. And the other hand, they need to report to the authorities on the state of human resources through bureaucratic procedures, health statistics, and other requirements. They must classify, identify deviations from the “permissible norms,” and record them. It creates a problem of dual responsibility: responsibility to the individuals affected, as a professional, and responsibility to the state.

There is a functional emphasis on population health. The representatives of Soviet Marxism initially prioritized “productivity” and populations as practical and usable resources. This trend has since continued, only with a changed ideological framework, finding an ally in the Russian Orthodox Church. In the context of the contemporary discussion about the “traditional values of the family,” Intersex people often cannot perform the function of “reproduction,” and they are seen as “rejected material .” Intersex people fit into a “disability” (or dysfunction) model, only existing within specific parameters.

Soviet medicine continues to influence medical practices, with cheap and accessible treatment delivered in ways that are ideologically compatible with authoritarian forms of government. Western medicine is considered only when it does not lead to profound changes in the system or any loss of control unless it can generate money. The variability of intersex bodies has no role in such scenarios.

Besides it, there are many additional challenges for intersex people in Russia. The first challenge is linguistics. The word “intersex” has an ambiguous Russian translation. The term “sex” is not translated as biological sex, biodiversity, or corporeality but instead usually carries a meaning related to sexual behavior and sexual orientation. The result is that the sociopolitical and legal understanding of the definition of “intersex” is lost.

The second challenge is the taboo topic of “sex and sexual education.” All phenomena perceived outside the conventional gender binary system are considered medical and rarely discussed at scientific conferences and seminars.

The third challenge is the medical community and its relationship with intersex people. Medical experts continue to use the “innovative” Soviet approach, namely surgeries on intersex children and management to control psychosexual adaptation. There are hundreds of operations on intersex children and adolescents without any monitoring by civil society organizations or ethics committees. Those ethics committees include representation by the Russian Orthodox Church.

Intersex children are categorized under “sexual perversion,” requiring special psychosexual adaptation to manage sexual orientation and gender identity. The aim is to “normalize” the behavior of intersex children under their assigned sex [12].

Another feature of this medicalization is that intersex children and sometimes adolescents are wholly excluded from information exchanges between doctors and their parents or guardians.

In addition, the selective abortion of intersex embryos takes place. Neonatal screening is routine in Russia, including for congenital adrenal hyperplasia, but the test results are not disclosed; statistical data is not publicly available. Doctors report limited information directly only to affected adults.

The fourth challenge for intersex people in Russian society is the high level of xenophobia and homophobia and, in particular, a correlation between intersex people and the LGBTQ community. On the one hand, the intersex community is afraid to join LGBTQ, as this will inevitably create additional discrimination against us in a very homophobic society. On the other hand, the LGBTQ community itself has an intersex phobia. It is not accepting of intersex persons due to internalized homophobia. The result is that intersex people who are also same-sex attracted and/or transgender are forced to live in a “double closet.” The situation for people with HIV is similar, and triple discrimination can occur if an intersex person has HIV. It inevitably leads to depression and other negative psychological states. Moreover, many LGBTQ organizations use the letter I in acronyms, but only superficially, without helping intersex people; often, these organizations only represent the LG group.

Another critical challenge is the quality and cost of medical services and their availability for intersex people. For example, some intersex people consciously seek disability to obtain discounts on treatment. It comes at the cost of discrimination against people with disabilities in the workplace, but there are often more significant worries about access to medication.

Thus, from the moment of birth and throughout subsequent stages of life, intersex people are faced with several social, legal, psychological, and medical problems. Intersex persons face normalizing operations, regular medical examinations, and sometimes special monitoring and “necessary” medical or psychosexual experiments to manage sexual orientation and identities. Outside healthcare, Intersex people live with the reality of a repressive patriarchal, heteronormative society and, in some cases, homonormativity. It includes taboos about a discussion of biological variations, especially when these relate to sexual variability and the silencing of descriptions and language relating to intersex bodies, even in so-called liberal academic circles. Consequently, it leads to bullying, discrimination, violence, and more.

Despite this challenging situation, the first intersex initiative in the region originated in Ukraine in 2011, perhaps due to the geographical and geopolitical location of the country, its proximity to Europe, and openness to new ideas. The first intersex activist in Post Soviet Union region was Julia Pustovit, who has been seeking to change the gender on her passport since the 2000s. Still, the Ukrainian medical system can only “help” change documents for transgender people diagnosed with “transsexualism,” not those with an intersex variation. Intersex people need to hide their biological status, or they can become transgender and lose access to medical help for issues associated with their intersex status. Julia began to look for other intersex people who would be interested in providing social changes.

Aleksander Berezkin was the first Russian intersex activist on the Russian-speaking internet. By this time, he had known about his intersex variation, 47 XXY or Klinefelter syndrome, for over 10 years. At first, he looked for information on intersex activism and contact with foreign intersex activists; his first contact was with the American intersex activist Hida Viloria. These contacts influenced him, and he started working as an Intersex and LGBTI activist, organizing educational events on intersex issues for the LGBTQ community in Vladivostok. With support from Julia, Aleksander founded the first intersex organization in Russia called “Association of the Russian-Speaking Intersex” (ARSI) for intersex people and allies in August 2013. Gradually, information about intersex people and intersex activism is beginning to spread in the Russian segment of the internet, especially among LGBT activists. However, in 2014 Aleksander was forced to leave Russia as a result of a homophobic campaign against him.

Nevertheless, when Aleksander started living in the United States, he gained the “privilege” of being openly an intersex person in the Russian-speaking space without the fear of physical bullying. He also got direct access to English-language sources of non-pathological information for intersex people, and he became able to distribute this in Russian-speaking spaces.  The first Russian language publication about intersex activism was published in 2014 [13]. In December of that year, LGBTQ activists held the first public action in Moscow to defend intersex children with the poster “Intersex. They make enforcement operations on genitals in infancy. Enough!”. 

Over time, the number of intersex activists has increased; new participants came to join ARSI, including intersex people from Ukraine and Kazakhstan. The recognition of intersex issues has begun in the Post-Soviet Union region. Currently, there are 5 different intersex organizations in Russia, one in Ukraine, and 7-8 public intersex persons who still continue the fight for their LGBTQI Human Rights.

***

[1] Roldugina, I. Intersex: from pathology to new opportunities// Queerfest 2013. 20 years after the abolition an article 121 of the criminal code of the RSFSR. Saint-Petersburg. 2013.
[2] Healey. Dan. Bolshevik sexual forensics: diagnosing the disorder in the clinic and courtroom, 1917-1939. Northern Illinois University Press, 2009.
[3] Roldugina, I. Intersex: from pathology to new opportunities// Queerfest 2013. 20 years after the abolition an article 121 of the criminal code of the RSFSR. Saint-Petersburg. 2013.
[4] Healey. Dan. Bolshevik sexual forensics: diagnosing the disorder in the clinic and courtroom, 1917-1939. Northern Illinois University Press, 2009.
[5] Golubeva I. V. Hermaphroditism: Clinical Features. Diagnosis. Treatment. Moscow, 1980.
[6] Changes rules, additions, and corrections of the records of civil status act 1977. Article.2., point T. Available from: http://www.businesspravo.ru/Docum/DocumShow_DocumID_33511.html – 20 October 2016
[7] Serdyukov, G. M. Forensic gynaecology and obstetrics. M. 1964
[8] Kalinchenko N. Yu, Tulpakov A. N. New classification of diseases connected with disorders of sex development. Discussion of the international consensus on the revision of terminology and classification of hermaphroditism. Available from: http://cyberleninka.ru/article/n/novaya-klassifikatsiya-zabolevaniy-svyazannyh-s-narusheniem-formirovaniya-pola-obsuzhdenie-mezhdunarodnogo-konsensusa-po-peresmotru – 20 October 2016
[9] Journal of “Andrology and genital surgery”. Volume 16, No. 3 (2015)
[10] The draft Federal law “On Legal Foundations of Bioethics And Guarantees of Its Security”, 2001. Available from: http://www.hrights.ru/text/b10/Chapter3.htm – 20 October 2016
[11] The RESOLUTION of 15 March 2001 No. 1253-III GD. Available from: http://www.medinfo.ru/medzakon/zdrav_rf/organ_act/azo75.phtml – 20 October 2016
[12] Scientific library of dissertations and abstracts. Available from: http://www.dissercat.com/content/khirurgicheskaya-taktika-pri-gipospadii-u-detei-s-narusheniem-formirovaniya-pola
[13] Berezkin, A. The intersex – between sexes. Available from: http://bok-o-bok.ru/opinion.asp?pid=28&lan=2&tid=1192 – 20 October 2016