Endocrine Abstracts

Background: In Germany, §1631e Civil Code allows parents to consent to surgeries that adjust their child’s bodily appearance to normative ideals of male or female, provided the surgeries are deemed medically necessary. However, parents’ consent requires authorization by a family court. Our research investigates the court decisions taken so far according to §1631e GCC. Previous research on medical treatment of VSC has demonstrated how guidelines refer to social and cultural norms when assigning a gender to an intersex child (e.g., Karkazis, 2020; Kessler, 1990). Our research wants to extend the research on medical interventions on children with VSC to the legal arena.

Methods: Based on a qualitative analysis of 40 unpublished decisions by German courts between 2021 and 2024, we analyze courts’ definitions of the best interest of the child by coding the documents openly and independently (Emerson et al., 2011) with MAXQDA. After determining key categories, a second round of closed coding using categories deducted from the legal regulations followed.

Results: We have identified seven tropes in the analyzed court decisions: 1) ambigious genitalia challenge a healthy psychosexual development, 2) parental insecurities with a child’s genitalia challenge the child’s psychosocial development, 3) ‘ambigious’ genitalia aren’t functional for sexual intercourse, 4) Being sexed binarily supports the child in feeling normal, 5) Surgery results are better at a younger age, 6) Early surgeries cause less pain/trauma, 7) Surgeries at a younger age avoid medical complications in the future.

Conclusions: Courts grant permission for surgeries on children with VSC by relying on arguments involving normative standards about a good life. Embodied intersex lives are not considered. We argue that by not considering possible alternatives for people with VSC, courts strengthen the medical role in the management of VSC.