Intersex people in Zambia struggle to have their gender identity properly recorded on legal documents because the law does not recognize their existence. They are often asked to produce results from expensive medical tests to prove their status and face official hostility because being intersex is often associated with homosexuality, which is illegal in the country.
LUSAKA, ZAMBIA – For most of his life, Gift has identified as female.
But now, at 31, he feels that the gender his parents assigned to him at birth was wrong.
He is three years into the long and still-undefined process of changing the gender on his Zambian national identity card.
“My parents chose to raise me as a girl, but I don’t feel that I am female. I am male,” says Gift, who asked that his last name be withheld for fear of discrimination. “I have started the change of my documentation, but it is a struggle.”
When her baby was born, Adesi, Gift’s mother, who also asked that her last name be withheld, says she opted to raise Gift as female because she says she thought the baby “looked like a girl.”
But in the months after his birth, she says she became unsure and depressed.
“I was confused when the baby was born,” says Adesi. “It took a lot of counseling from my church members and some friends for me to accept the reality that I had an intersex baby,” Adesi says. “I had never heard about it. It was so disturbing.”
She says doctors instructed her to observe the baby’s behavior and appearance, but it wasn’t until Gift was a teenager that he started to identify as male, when his appearance became more masculine than feminine.
“I was hopeless. I did not know what to do,” Adesi says. “So I kept grooming my child the way I thought was best.”
Intersex people are born with physical or biological sex characteristics that do not fit the traditional definitions of male or female, according to the World Health Organization. In Zambia, intersex people are often referred to as “hermaphrodites,” a term considered outdated in other parts of the world. Globally, intersex people are considered part of the lesbian, gay, bisexual and transgender movement because they are sexual minorities, which complicates matters in places such as Zambia, where homosexuality is illegal.
Gift is not homosexual, but says that he faces constant discrimination because being intersex is misunderstood. In the process of changing basic information on his national identity card, for example, he has spent years explaining to officials and presenting medical evidence that being intersex is not illegal because it’s a physical condition.
The National Registration Act of Zambia requires that all citizens over the age of 16 possess an identity card which contains basic information such as date of birth, name, address, gender and level of education.
Section nine of the act, which is commonly used to process name and address changes, could be interpreted to allow for gender changes, too. But for intersex people in Zambia who want to change the gender with which they identify, the process is nebulous, requires medical testing and has yet to be resolved.
The form requires just a few pieces of basic information, including name, gender, address and level of education — all of which should be able to be amended, according to the law.
Section nine of the law says that at any time that an identity card fails to accurately represent a person’s identity, “such person shall, without undue delay, produce his national registration card and give such particulars as shall be necessary for the issue of a new national registration card to a registrar who, on payment of any fee and subject to any conditions which may be prescribed, shall issue to such person a new national registration card.”
Most of the change requests are for name changes, says Levy Lilanga, public relations officer for the Ministry of Home Affairs, which is responsible for issuing national registration cards. “There are a lot of requests for corrections on national registration cards.”
Lilanga says it’s not possible to know how many of the pending change requests are for those seeking gender changes.
Up to 1.7 percent of the world’s population is born intersex, according to the Office of the United Nations High Commissioner for Human Rights. The exact population of intersex people in Zambia is unknown, says James Chipeta, associate professor of pediatrics and clinical immunology at the University Teaching Hospital (UTH) in Lusaka. He says about 90 children born at the teaching hospital, over a period of 10 years, have been labeled as intersex. While he says there are well-honed processed for handling intersex births at UTH, he says their protocols are not standardized nationwide.
The rights of intersex people have not been studied or widely discussed by lawmakers here, says Dr. Maximillian Bweupe, a medical doctor and the spokesman for the Ministry of Health.
The fact that intersex people are associated with the lesbian, gay, bisexual and transgender population is what has likely led to their lack of recognition, says Landilani Banda, human rights advocate and law lecturer at the University of Zambia.
“It has been tough. I started the process in 2014, but they told me I needed supporting medical evidence to prove that indeed I am intersex,” Gift says. “I had to do a whole lot of tests, some were not even done in this country, and all that costs money.”
Chipeta, of the University Teaching Hospital, says the registration system might require karyotyping tests, which assess chromosomes, or ultrasounds to determine the presence of ovaries or a uterus. Hormonal assessments might be requested to test for levels of testosterone and estrogen. Even a CT scan or MRI of the brain might be requested. But there are no regulations to define which tests are needed.
Gift did some of his tests in Zambia, but he also had to travel to neighboring South Africa where more-sophisticated equipment is used.
“These tests are not readily available in our hospitals,” Chipeta says. “It’s only done in private labs or South Africa.”
But other intersex people have reported different required processes, demonstrating that Zambia does not have a defined procedure in place for accommodating gender changes on national identity cards.
Prisca Chilufya, 18, another intersex person, says it took her more than four months to obtain her first national registration card.
Chilufya identifies as female, the gender that her parents assigned her at birth. But she says because her appearance is very masculine, people misunderstand her. When she requested the female gender on her national registration card, she says it was not granted, despite her explanation of being intersex.
“There was drama at the registration office the first day I went to get my national registration card,” she says. “People came to make fun of me when they heard that I had a female name, they thought I was joking. I explained that I was intersex, but most people said they had never heard of such. I was later advised to bring medical evidence from the hospital.”
Chilufya says she completed the required medical testing and was still sent back and forth between the hospital and the national registration office several times.
She says she almost gave up, but recently received her national identity card that identifies her as female.
The fact that she was getting her card for the first time and not changing her gender is likely why she was successful, Banda, the human rights advocate, says.
“There is no documented process that intersex people use to make changes to their registration cards, there is nothing outlined for recognizing intersex people.”
Chilufya says she is proud to identify as intersex but wishes there could be laws that could allow her to be identified as such on legal documentation.
In the meantime, Gift remains hopeful about changing his gender on his documents.
For Banda, stronger human rights provisions in Zambian law are needed.
“The law must take a leap and recognize that we have intersex people in this country,” she says. “We can’t leave it to the discretion of those in authority when it comes to obtaining documentation and recognition of intersex people.”
Prudence Phiri, GPJ, translated interviews from Nyanja.