BELGRADE — In a troubling chapter of medical history, Kristian Randjelovic, born in the capital of the former Yugoslavia, became a victim of an agonizing and relentless medical blunder that would haunt him for decades.
As an infant with indeterminate sexual characteristics, he was subjected to a surgical procedure that “assigned” him a female identity, as doctors clung to outdated binary notions of gender in a misguided attempt to shield him from potential lifelong distress.
The consequence of Randjelovic’s “sex normalization” surgery was a tumultuous childhood characterized by self-doubt, pervasive bullying, and psychological torment, leading him through a long and painful journey that ultimately involved psychotherapy and culminated in sex-reassignment surgery (SRS) at the age of 19.
‘Sex Normalization’ Surgery
For nearly two decades, Randjelovic bore the weight of a female name despite identifying as male, grappling with the severe physical and psychological aftermath of an ill-conceived operation whose repercussions became glaringly evident to him. He lamented the absence of any detailed information about the surgery he underwent as a child, with his family offering no insights or clarity.
“Very early on, the question for me was, ‘What is this that I have?’ and ‘Why can’t my body perform something that I’d like to do?'” These inquiries marked the beginning of his struggle to understand his identity and body.
In Serbia, where Randjelovic was raised, numerous intersex infants underwent similar surgical interventions up until a decade ago, before the medical community was swayed by mounting evidence and intense international scrutiny, which revealed that such procedures generally inflicted more harm than good.
The World Health Organization (WHO) defines intersex individuals as those “born with natural variations in biological or physiological characteristics (including sexual anatomy, reproductive organs and/or chromosomal patterns) that do not fit traditional definitions of male or female,” underscoring the complexity of human biology.
There is no correlation with gender identity or sexual orientation, emphasizing that intersex conditions exist independently of these factors.
This narrative resonates globally, with implications affecting millions of individuals confronted with societies grappling with evolving definitions of sex and gender. The UN estimates that up to 1.7 percent of the global population is intersex, which translates to over 110,000 individuals in Serbia alone, illustrating the scale of the issue.
Accidental Activist
Despite the pervasive stigma surrounding intersex births, progressive laws addressing these issues remain scant, particularly in socially conservative post-communist nations. Intersex activists highlighted alarming practices as recently as 2017, when Russia’s Health Ministry publicized a clitoridectomy and vaginoplasty on a 3-year-old intersex girl, which was disturbingly live-streamed during a medical conference.
Since seeking psychotherapy as a teenager and sharing his experiences with medical professionals, Randjelovic has evolved into an inadvertent activist and has courageously claimed his identity as the only openly intersex individual in Serbia.
However, he acknowledges that there are undoubtedly others who remain silent due to societal pressures.
The European Commission expressed concerns in its latest evaluation of Serbia’s progress toward European Union membership, noting that intersex citizens are rendered “socially and legally” invisible within the country, emphasizing the need for greater representation and rights.
Social scientists argue that a prevailing Balkan culture of intolerance toward diversity creates formidable barriers for those identifying as “gender neutral.” Serbia’s Law on Civil Records mandates that newborns be classified strictly as either male or female—there is no provision for a third gender, unlike Germany, which has allowed parents to leave the “sex” line blank since 2019.
“Socialization is possible only in binary affiliation: You’re either a boy or a girl, and that’s the end of it,” explains Zorica Mrsevic, a former jurist and professor specializing in gender and rights issues in Belgrade.
In April, the European Commission Against Racism and Intolerance (ECRI), an oversight body of the Council of Europe, criticized Serbia for its alarming absence of official data regarding “sex normalization” surgeries performed on intersex children.
These numbers remain elusive. The Institute of Public Health-Dr. Milan Jovanovic Batut in Belgrade, the country’s primary center for public health data, did not respond to inquiries regarding intersex figures for Serbia, leaving a significant gap in understanding.
‘Are You A Boy Or A Girl?’
Vladimir Kojovic, a veteran specialist in pediatric surgery and urology at Serbia’s state-run facility for intersex children, boasts 25 years of experience addressing intersex issues. He asserts that neither his institute nor any other medical facility in the nation has performed these controversial surgeries for approximately a decade.
Nonetheless, his team at the Dr. Vukan Cupic Institute in Belgrade encounters around 10 cases annually involving newborns with indeterminate sex characteristics, challenging the binary classification imposed by society.
“At birth, we [usually] have a baby with signs of both genitals — so genitals of both sexes,” Kojovic acknowledges, emphasizing the diversity of intersex conditions and the impossibility of predicting an individual’s future gender development based solely on appearance.
Doctors have since monitored the long-term outcomes of infants who underwent “sex normalization” surgeries in Serbia. “We saw that mistakes were made,” Kojovic states, confirming the detrimental effects of such procedures.
Randjelovic, the only publicly recognized victim of these medical interventions, reflects on the prevailing belief at the time that conducting an operation during the child’s early years was considered the least traumatic approach for the child.
However, he asserts, that “didn’t turn out to be correct” as he revisits the painful memories of elementary school where classmates bullying him relentlessly asked, “Are you a boy or a girl?” or taunted, “You have a female name, [but] you don’t look like a girl.”
He recalls a significant lack of representation in the media during his formative years, only encountering discussions about sexual minorities and intersex issues in magazines and television during the 1990s. His journey toward understanding his identity was greatly assisted through psychotherapy, allowing him to glean critical insights into his experiences. He met another intersex person for the first time around the age of 30 at a conference held abroad.
Currently, Randjelovic leads a nonprofit organization named XY Spectrum that champions the rights of intersex individuals and offers support to the parents of intersex children in Serbia, including collaborations with the Dr. Vukan Cupic Institute, the former site of “sex normalization” surgeries.
“You first have to become clear to yourself,” he asserts, emphasizing the importance of self-awareness before communicating one’s identity to others and fostering meaningful connections.
