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Why intersex activists are fighting for constitutional protections in Ghana.
To get ahead of the odds against them—an unsympathetic media, a punitive legislature influenced by the American Christian right, and a public uninformed about biological diversity—the intersex movement in Ghana has had to get crafty.
In January 2025, the Ghanaian government announced a new constitutional review process, instituted by President John Mahama shortly after he was sworn in. Its main aims were to “propose reforms to enhance transparency, limit executive power, strengthen checks and balances, and improve judicial and local government structures."
In it, however, the intersex movement saw an opportunity: All of Ghana’s constitution could be reviewed. This included Article 17, which states that all are equal before the law and no one is to be discriminated against on the basis of race, place of origin, political opinions, color, gender, occupation, religion, or creed. If the movement could propose a review of Article 17, they reasoned, perhaps they could amend it to explicitly include that no one could be discriminated against based on their sex characteristics, or if they are of indeterminate gender (intersex).
It seemed like a solid plan.
After several strategy meetings, legal review, and input from constitutional law experts, however, the leaders of the movement realized it would not be so straightforward. Article 17 represented an “entrenched position," meaning a long-held view that was unlikely to change. As such, not only would it be difficult to convince the public of the importance of including intersex people for protection under the constitution, socially; legally, it would also require a referendum to pass.
The intersex movement already had only a few allies among the political class, and based on their findings, they also knew a majority of the public did not understand the concept of indeterminate gender—that someone may be born male with female sex organs, for instance, and should not be discriminated against for something out of their control. Making matters worse, the media also regularly conflated sexuality with gender in bad faith: A slate of investigations by friendly NGOs had revealed some major media organizations had even received funding from anti-LGBTQIA+ rights groups.
They changed tack.
Instead, the movement decided to seek an intervention through Article 28, which provides for the protection of children’s rights. They proposed that the provision be updated to explicitly ensure the recognition and protection of intersex children, who, in Ghana, are currently subjected to “corrective” and “forced” surgeries and medical procedures, according to firsthand accounts reported to Intersex Ghana, the country’s first intersex-led human rights organization.
Specifically, the group hoped to protect intersex children from “medically unnecessary, nonconsensual and irreversible procedures, intended to alter their sex characteristics.” These speculative procedures—sanctioned by doctors and parents without due consideration for the well-being of the child—can have lifelong physical, psychological, and even economic consequences, impairing the child’s ability to make a living in the future, says Lawrence Shone Edem Adjei, director of Intersex Ghana, over a video call.
"At age 14, I have undergone more than six surgeries after non-consensual procedures were performed on me at birth. I feel like the doctors used me for studies,” intersex advocate Emmanuella Kwarteng shared in one testimonial.
Kwarteng’s experience is not an uncommon one, and Intersex Ghana has had to intervene in a number of medical cases gone awry. In one particular case, Adjei recounts that a child had gone through up to eight surgeries over a span of ten years. Initially, their testes were removed, and the child was identified as female. Years later, doctors realized their initial procedure had caused the child to begin bleeding internally during menstruation. An additional surgery then had to be performed to remove the child’s womb.
“It's like just trial and error," Adjei says.
To make the case for intersex children in front of the constitutional review committee, and to prevent this from happening again, the intersex movement put together a murderer’s row of accomplices. Alongside activists like Adjei, this included two doctors, three lawyers, a High Court judge, and families with intersex children who could share their lived experiences.
It was a particularly precarious time: The intersex rights movement was working with significantly fewer resources than it had ever had. Intersex Ghana and other NGOs had been depleted by the U.S.-led funding cuts to pro-LGBTQIA+ rights advocacy groups all over the world, and philanthropic support had dried up.
The movement was throwing everything it had left at this case. Before the constitutional review committee, it had a few propositions. First, that the Ghanaian government provides an additional gender “I” (or intersex) on its Birth and Death registry upon discovery at birth that a child is not identified with one gender. Second, that the Ghanaian government outlaws and criminalizes forced surgeries to deter doctors from performing them, regardless of the demands of the child’s parents. Controversially, by Adjei’s own admission, “We are not in favor of the parents serving consent.” Instead, the movement proposed that the intersex individual be allowed to develop naturally. When the child is of age, they can then make an informed decision on their own bodies.
The advocates made their case to the constitutional review panel, drawing precedent from a case in Kenya. In the 2014 case, Baby A v Attorney General, an intersex child was denied a birth certificate because their sex had been marked with a question mark, effectively barring them from participating in civic life. The court, hedging, declined to admit a human rights violation, but still ordered the state to issue the birth certificate and begin the slow work of collecting data, developing medical guidelines, and contemplating a legal framework for intersex people. As a result of the case, the Kenyan government is now mandated to collect data on intersex individuals, and consider legal reforms and protections for them more broadly.
This landmark court case eventually resulted in an Intersex Persons Bill in 2024 which, among other things, guaranteed the “prohibition of harmful medical practices” against intersex people—including children.
The advocates argued that Ghana should follow Kenya’s example and recognize intersex people as a distinct legal entity, allow for intersex markers in civil documentation, include intersex persons in national census and data gathering, and establish a national commission for intersex individuals. They further argued that the condition of being “intersex” is not in conflict with Ghanaian cultural values by demonstrating support from religious and traditional leaders.
After months of deliberation, which included hearing from anti-intersex and anti-LGBTQ+ groups opposed to the proposed changes, Ghana’s constitutional review committee reached a decision. They recommended to the government that the constitution be amended to “provide for the right of every child to bodily integrity, including freedom from irreversible, non-consensual medical or surgical interventions that are not strictly necessary to preserve life or prevent serious and immediate harm; that the best interests of the child shall override social, cosmetic, cultural or expediency-based justifications for invasive medical procedures; for protection for intersex children, recognising their distinctive vulnerability to medically unnecessary ‘normalising’ interventions carried out before informed consent is possible.”
The movement was thrilled.
Their excitement, however, was short-lived. Soon after the committee submitted its recommendations, anti-intersex rhetoric started appearing in the press. On a national news show, Ghanaian legislator Nana Agyei Baffour Awuah called the proposed protections the “most crucial” part of the constitutional review, claiming the changes would “transform our constitution”—but not for the better.
“We know that these things can be the entrance of LGBTQ,” Awuah said, repeating a common trope widespread in the media that conflates sexuality with gender. “You want to sneak this into the constitution!”
Awuah was not accusing anyone in particular with his statement, but turned to fellow guest Oliver Barker-Vormawor, an activist and lawyer involved in the constitutional deliberations. In response, Barker-Vormawor defended the committee’s recommendations.
“We're saying that these are medical decisions that must be made, not parents using cultural basis to demand for surgeries to be imposed on children,” Barker-Vormawor said, reiterating their intentions.
In reality, the intersex movement in Ghana has gone to great lengths to distance itself from the LGBTQ+ movement as a safety and security strategy. It is also one of the biggest criticisms the movement faces from its potential allies. When an anti-LGBTQ+ bill was first introduced in Ghana in July 2021, intersex advocates campaigned tirelessly for the removal of intersex persons from the law, which included recommendations for surgery and hormonal treatments to “correct” them. Later that year, Intersex Ghana sent a memo to the Ghanaian legislature’s Committee on Parliamentary Affairs, asking for the bill to be thrown out in its entirety. But overall, the movement continues to tread the line between distinction and solidarity with its LGBTQ+ allies as best it can.
Still, some argue the two movements are ultimately inseparable because of their intersections: There are people who are intersex and trans; or intersex and gay.
“The movement has become too medicalized,” intersex and trans activist Awo Dufie Fofie says.
Dufie, assigned male at birth, later discovered she was intersex in her 20s, and initially went great lengths to reverse the growth of breast tissue in her body. At some point, she was taking fifteen pills a day. Upon meeting a queer elder—who had also been born a hypereffeminate male, but had socially transitioned to female in the 1950s—Awo stopped blocking estrogen in her body and instead let her body develop as it would without pharmaceutical intervention.
The intersex movement often has to make its case through visual aids of intersex bodies, Dufie argues, and as such, she believes it has created “a system that becomes a bit puritan about who can rightfully call themselves intersex and who is intersex enough to represent the community.” When Awo decided to transition, she was even advised by a fellow advocate that if she made it public, it would make the intersex movement “look bad."
"It is my sincere hope that intersex advocacy…adopts a much more decolonial framework and approach which embodies and centers the entire experiences of intersex people, such as their everyday lives,” she says. “Not only what medical conditions we have and how much intersexphobia we experience.”
Adjei acknowledges the catch-22 the intersex movement finds itself in, and understands why it believes it has to advocate for itself by providing distinctions between sexuality and gender. But she also believes it must also be in solidarity with the queer movement because of their overlap and intersections—including continued discrimination. “Ghanaians will not differentiate between an intersex person walking by and an LGBT person,” Adjei says. An effeminate but masculine-presenting intersex person is just as likely to be attacked—as has happened in many cases across the country—as a gay man expressing himself in a way that might be considered feminine.
“I was not seen as human growing up… because I had two genitalia,” Comfort Bugre, an intersex person, shared in a testimonial presented to the review committee.
“Growing up, I was isolated from people due to my intersex condition. I was relocated because people found out and started calling me names,” Elorm Enne, another intersex advocate, shared in a separate testimonial.
Currently, the hard-won constitutional review recommendation is in the implementation stage, and the Presidency has set up a committee to see how proposals may be effected.
The intersex movement is counting on seeing three things: First, large scale research on intersex people across the country, both to shed light on the quantitative heft of these protections, and to better understand the prevalence and diversity of intersexuality. Second, mass sensitization and public education across the country’s 16 regions on the harms of corrective child surgeries, in partnership with key institutions such as the Human Rights Commission and the National Commission for Civic Education. And perhaps most importantly, the legitimacy of intersex as its own gender, and protection for all intersex people in the country.
The movement is tempering ambition with pragmatism. Advocates are also preparing for an outcome where the recommendation is struck down, or isn’t implemented, either in whole or in part. But if this comes to pass, the movement—with whatever funding it has left—plans to play its trump card. There are a number of government agencies and offices that should be involved in protecting intersex children: medical boards, the Attorney General’s office, the Ministry of Health, local government administrations.
It plans to sue all of them.
~
Additional Research by Nyameye Kiki Akumia.
[post_title] => "I Was Not Seen as Human Growing Up"
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