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Interview: Dr Small Luk talks gender struggles and the dangers of good intentions

“It's not the intersex person that needs changing, it’s society"

With the International Day Against Homophobia and Transphobia adopting an I, for intersex, Arthur Tam talks to Dr Small Luk about her struggles growing up as an intersex individual and the dangers of good intentions

If you’ve ever wondered what the ‘I’ stands for in LGBTI, even Time Out staff were initially bewildered once the letter was added to this section’s name last year. It stands for intersex – ‘a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male,’ according to the Intersex Society of North America. Basically, Intersex is its own category of gender. It’s a rare occurrence, but not as rare you might think. Globally, approximately 1 in 1,500 to 1 in 2,000 children are born with noticeably atypical sexual traits. There are even more cases when you account for subtler sexual anatomical variations. 

Just calling someone intersex can have a variety of different meanings. There are 17 different known intersex conditions that are either a result of an anomaly on the chromosomal level or physical anomalies where outer sexual characteristics and genitalia are ambiguous. It’s not easy to pinpoint, which can be unconformable for folks that are hell bent on defining gender, but in reality there’s more than just male and female. The sex spectrum is very much like the varying hues of the colour spectrum. 

This year, Hong Kong is taking another progressive step as IDAHOT (International Day against Homophobia and Transphobia), an annual gathering to raise awareness for LGBT rights, taking place on May 17 (location yet to be confirmed), is adding an ‘I’ to its name and evolving to IDAHOTI. This event is an important global happening that is now recognising an even more overlooked part of the community. (Join the karaoke fundraiser at at Volume Beat to cover the costs of the event on Wednesday May 6.)

So who are the intersex people living in Hong Kong and what difficulties do they face? Dr Small Luk, a lecturer, counsellor on sexuality and traditional Chinese medicine doctor, is one such individual. Formerly classified as male, she is now legally a woman and bears the scars of her childhood as an intersex individual. 

Dr Luk suffers from a condition known as Partial Androgen Insensitivity Syndrome (commonly referred to as PAIS). You might remember from early biology classes, that androgens are a hormone that stimulate the development of male sexual characteristics. Testosterone is an androgen. So, although Dr Luk is genetically a man with XY chromosomes, her cells don’t completely respond to testosterone, leaving her with an underdeveloped penis, undescended testicles and a body with more feminine looking features. Dr Luk is now 50 years old, but it wasn’t until she was 36 that she discovered she had PAIS (people with the condition usually don’t discover it until adulthood). Doctors recommended that Luk should undergo reassignment surgery to become a women because her type of PAIS would most likely cause cancer. The surgery was a success, and now Dr Luk is legally a woman, but she still identifies as intersex and sexuality-wise, prefers woman. “I was even more confused when I found out I had PAIS,” she recalls. “I went from being a defective male to something that wasn’t man or woman. I really thought I was a monster. But I eventually came to terms with it and realised I could help people by talking about my experience, which gave me comfort.”

Growing up in Hong Kong in the 1960s and 70s was extremely difficult for Luk because doctors back then told her she was a defective man and required surgical corrections. She was bullied, harassed and even molested during her time at school because of the way she looked. Saying she struggled in life would be a gross understatement. She had more than 20 reconstructive surgeries between the ages of eight and 13 and even then, the reconstruction wasn’t fully realised  — leaving her unable to properly use a toilet. Medical science 40 years ago wasn’t advanced enough to help and signifcantly interrupted her life, but she prevailed. “I hope to be a good role model for intersex people. I want them to know that they can succeed and live a full life.”

This year for IDAHOTI, Dr Luk has been part of a series of lectures taking place on the campuses of HKU, CUHK and HKBU talking about what intersex means. She is particularly keen to advocate that doctors and parents stop assigning a gender to an intersex child. Many intersex children are forced into specific genders at an early age through surgery in order to avoid the societal hardships associated with growing up as an intersex individual. Although the intentions from parents and doctors are well-meaning, they are guessing, with a 50/50 chance of choosing correctly, the gender their child actually identifies with. If they choose wrong, this individual grows up with extreme emotional and physical distress and is most likely forced to undergo invasive gender reassignment surgery for a second time in order to rectify the original mistake. And in some cases, intersex people are perfectly comfortable being intersex and don’t need surgery. Dr Luk advises giving intersex people freedom to choose and let them decide for themselves when they are older. 

There is progress — just last month, on April 1, Malta became the first country to outlaw non-consensual medical interventions to modify sexual anatomy, including that of intersex people. “Growing up as an intersex person can be very difficult, but that’s a problem society places on that individual,” says Dr Luk. “It isn’t the intersex person that needs changing, it’s society. We take away someone’s rights and choices if we decide what gender they are. It doesn’t matter if parents or doctors have good intentions.”

IDAHOTI Sun May 17 (location TBC); IDAHOTI Facebook page.

Follow Arthur Tam on Twitter @TOHKarthur

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