This intersex activist endured forced surgery as a baby. Here’s what happened when she grew up.

Many people could tell you that the I in LGBTQIA stands for “intersex,” but most would be hard-pressed to define what that really means. Texas activist Alicia Roth Weigel wants to change that.

Weigel’s new memoir, Inverse Cowgirl, tells her story of being born with both male and female biological characteristics. Like many intersex people, her story is one of shame, revelation, and eventual acceptance. But in this collection of essays — each anchored by one of Weigel’s tattoos — she also demonstrates an inspiring level of activism. In addition to promoting progressive legislation, she appeared in the intersex documentary Every Body, and is serving as the City of Austin’s Human Rights Commissioner. 

Related:

We are here now: New documentary powerfully portrays intersex stories

Three intersex adults who had forced gender assignment surgery as babies are now fighting to ban the practice for good.

Weigel spoke with LGBTQ Nation from her Austin, Texas home to discuss her new memoir.

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LGBTQ Nation: You’ve probably gone through a lot of interviews by now. Is there anything you’d like to highlight that you haven’t been able to talk about as much?

Alicia Roth Weigel: The movie Every Body is great because it helps raise visibility in particular about the non-consensual surgeries that intersex kids face. That being said, I feel like we as intersex people are often reduced to these childhood surgeries. And I understand why so much of the media coverage focuses on those surgeries — because they’re such a flagrant violation of human rights. And when people hear it, I think they are pretty appalled and it draws them into our movement and it makes sense as an entry point. That being said, there’s such a focus on the violations we face as young people, and there’s very little focus on what happens after that. And not just in terms of our humanity and our identity, but also just in terms of healthcare. 

Like, you age out of pediatrics and there are no doctors that have any idea how to treat your body, what our bodies need, and there are really detrimental health outcomes that come from that. For example, I was diagnosed with osteoporosis at age 31 or 32 because I had not been getting the right kind of hormone replacement regimen that I would need to account for the childhood surgery that was forced upon me without my consent. And so there are a lot of intersex people walking around with bone density issues or having questions about their fertility. 

When you look at the statistics that came out of this nationwide survey of intersex people that I helped run, 65% of the intersex people that we surveyed across the country don’t even disclose their intersex status to medical professionals because we have so much distrust of the medical industry, whether because we’ve undergone childhood surgeries or because they have encouraged us to lie about who we are or because they have lied to us about who we are. And 51% of those that we surveyed have to travel 50 miles or more to even see a doctor who has any idea of what intersex even means or that our bodies even exist. 

We’re like 2% of the world’s population, that’s not a small number. It sounds small because it’s only 2%, but when you translate that into real human lives, that’s like 150 million people around the world. That’s equivalent to half the population of the United States. 

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LGBTQ Nation: What is some of the work you’ve done that you’re most proud of?

ARW: So I’ve been working directly with the Biden administration on compiling this report that the president mandated in his Pride Month executive order back in 2022. So it’s been a year and a couple of months now where he ordered the federal government to generate a year-long report on health inequities faced by the intersex community. I’ve been helping them compile that, like the Federal Bureau of Health and Human Services and other related agencies. That report should be released by the end of this year. It’ll be the first-ever federal policy actively addressing the needs of intersex individuals in the history of the United States. 

I’ve been working with a group here called Texas Health Action, which is the parent company of Kind Clinic, a set of LGBTQI+-affirming clinics across the state of Texas. They provide STI testing, HIV care, and gender care for trans folks. I consulted with them over the course of a few months. We ran a nationwide survey of intersex individuals and we ran focus groups with intersex Texans across the state. And we worked on compiling tons of data that then informed our creation of this intersex health offering, which does everything from helping intersex people access their medical records, which a lot of us need because we’ve been lied to by our parents and doctors, and so we don’t even know the extent of the surgeries or hormones that we’ve undergone.

It includes things like helping intersex people know if they need to get bone density scans or cancer screens and helps them access hormones, referral lists to endocrinologists, urologists, all different sorts of specialists that they might need that have at least seen intersex patients and that they know will at least be affirming to them and won’t be off-putting. So we’ve done so much work and we’ve created this intersex health offering. 

There’s no central clinic that intersex people can go to and be like, I have all these questions that doctors have never been able to answer for me, and then get all of those answers in an environment where they will be affirmed, and where they will not have people asking them creepy questions, and where they will not have to answer dumb questions like, you know, I walk in as someone who has XY chromosomes, I was born without a uterus and without ovaries and I’m sick of having to tell doctors over and over again like, no, I’m not pregnant and like, I’ve never gotten a period and like, no, it’s like, these are dumb questions. I’ve never even had a uterus. Of course I’m not pregnant.

As far as I know, we have created the first-ever healthcare offering for intersex adults in the United States. 

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LGBTQ Nation: One of the tattoos that guides your writing is a Spanish lyric about “tuning your own vibration.” What does tuning your vibration mean to you?

ARW: As intersex people, we’ve often been told who we are by parents, by doctors, and we end up living that life. And if we ever do choose to come out, it often requires unlearning what we’ve been molded into to figure out who we actually are. And I think that’s something that a lot of people in the broader queer and trans community can resonate with. 

A lot of us in the queer community have experienced a lot of trauma, and I don’t want to minimize that. That being said, I think I have realized that it can almost become a trap to be like, this happened to me and I’m so traumatized. And so I’m like, these are my circumstances and I’m a victim of circumstances. And I hope what my book can show is that we all have a lot more agency than we think or than the government wants to lead us to believe. All of these policies are meant to make us feel powerless and helpless. That is their intent. And we can’t let them do that because tuning your own vibration is really being like, No, I’m the one at the steering wheel. Like, I am the one in control and I have more power than our enemies want me to think that I do. And so in addition to unlearning what other people have told me, tuning my own vibration means learning positive and healthy coping mechanisms. 

Like, I used to drink a lot, I used to have a lot of substance abuse, I used to have a lot of indiscriminate sex, I used to do a lot more, like, numbing, I would say. And then I really learned to sit with my s**t; and I think writing the book was the biggest example of doing that, of really having to face all of my life and all the things that have happened to me and then make the choice that I’m not going to be what happened to me. I’m going to be what I make happen.

I think that’s what tuning your own vibration is about. It’s not just like singing the song of whoever’s next to you or conceding to the radio station that someone else put onto you. It’s being like, No, I actually am in control. I have the power here. And it’s not gonna be easy, and it’s not always necessarily gonna be fun, but we can all take the steps to like, learn how to vibe at the frequency that we want to vibe at, that’s gonna be healthy for us and be positive for us. And yeah, and like, let us live our best lives. That’s awesome.

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Inverse Cowgirl is available on September 19, 2023 from HarperOne. You can pre-order it on Amazon and Barnes & Noble. You can find Alicia Roth Weigel on Twitter and Instagram.

*This interview has been edited for length and clarity.