Struggling With Intersexuality

Word Count: 1818 |

Brittany Cinkowski
English Composition 1

One of the first responses after having your first child is whether it is a male or a female. However, for the parents of one out of 2-3,000 infants, it is not quite that simple. The issue of intersexed children has been on the rise the past couple of years. With new technology being brought forth to treat such children, the issue is often whether or not treatment such as surgery or hormone injections is ethical? Parents should, inevitably, hold off surgery until the intersexed child can decide for his or herself if they would want to have a sex reassignment surgery at all, and if they do, they should be able to decide what gender they feel most comfortable with.

A person is said to be “intersexed” when their internal and external sex organs are neither exclusively male nor female. Some questions arise as to what determines if you are a male or a female? Dr. Alice Dreger states that, “the clitoris in female infants are considered too big if they exceed one centimeter in length, and a males penis is considered to be too small if the stretched length is less than 2.5 centimeters, which often results in the male being given a female sex assignment”. (Bullough,1) Being intersexed is not always a condition that is found at birth. Sometimes a person is not found to have intersexed anatomy until he or she reaches puberty or even dies and is then autopsied. People can live their whole lives without knowing they have another set of internal sex organs. It is also important to remember that being an intersexed individual is considerably different than being a transgendered person. A person who is considered to be a “transgender” does not necessarily mean they were born with a mixed set of sex organs, it simply implies that the individual feels that they are a different gender then the one they were assigned to when they were born. Some people who are a transgender were born intersexed, though most of them were born with a distinctive male or female anatomy.

The outcome of a child being born intersexed almost always ends in surgery. Most often it is easier to construct the female genitalia than the male genitalia, which results in most intersexed people being girls after many surgical procedures. Even after the surgery is performed the patient has to take hormones to make them more like their assigned identity for the remainder of their life. Patients that go through sex reassignment surgery often struggle through-out their lives to find their “true” identity, generally feeling like an outcast among their peers. Immediate surgery is often performed when a child is born intersexed, but more genetic studies show that parents should rethink about the sex assignment surgery and wait until the child can give their opinion as to what gender they feel they can relate to more. This may take up until the child hits puberty. “A rival theory pushed by the ISNA advocates that except for minor surgical corrections, the decisions should be held in abeyance until the child at puberty can determine for himself or herself what kind of surgery is desired” (Bullough,1). Instead of performing a quick fix, doctors should be helping parents cope with their infants since society has not yet accepted the fact that sometimes a person is neither all male nor all female. The parents need to be willing to raise their sexually ambiguous children until the child is ready to give his or her consent on any surgical procedures. John Money writes in his book, Sex Errors of the Body, Dilemmas, Education, Counseling, that “the problem is to communicate the options to the parents more effectively without influencing them and then to support them in their decision” (Bullough,1). Cheryl Chase, an executive director of the Intersex Society of North America (ISNA) is strongly against the secret rushed surgeries that are often performed in the hospitals only days after an intersexed infant is born. Chase “hopes physicians will begin to see mixed sex characteristics as a lifelong medical condition instead of a problem to be quickly fixed” (Lehrman,1). She also goes on to say that “We do not attempt to solve the problems many dark-skinned children will face in our nation by lightening their skin after birth” (Lehrman,1).

On September 20th 2007, Oprah Winfrey, on her talk show, discussed people who are born intersexed. Oprah had on a guest named Marcia who did not know she was born with both sets of chromosomes until she was 35 years old. Marcia went on to say that the show was an important milestone because “I am talking about a condition that caused so much shame that my family and doctor hid the truth from me” (Smith,1).When Marcia was born in 1965 she appeared to be a healthy looking female, but inside she was lacking a uterus and ovaries, and had internal testes, instead. At the age of 12 she had surgery, without being given a reason, that removed her internal testes. She was also on hormone replacement therapy for the rest of her life. Not being told why she was having surgery and not having a choice in the matter is an invasion of her human rights. “Simply understanding and performing good surgeries is not sufficient. We must also know when to appropriately perform or withhold surgery” (Dreger,2).

The negative consequences of having sex reassignment surgery before puberty out weighs the benefits. The recent publication of the “John/Joan” case shows that sometimes children who are reassigned a gender get the “wrong sex”. In the John/Joan case, John was born a typical male with a twin brother but during his circumcision there were some complications and his penis was considered abnormal and non-functional. John then underwent surgery to have his testes removed and was reconstructed a female at 8 months old. He was also given hormone treatments through-out his life to make his body appear more like a woman. During his time as a female he never felt like he belonged. He thought himself to be a lesbian when he became interested in girls and was immensely depressed at the thought of being an outcast among his other girlfriends.
At the age of 14 he was told that he was born a male and he decided to revert back into a male. Eventually, he went on to marry and have kids successfully. John‘s situation is considered to be one of the luckier ones. Often patients feel disconnected from who they truly are and become severely depressed and are never told they had genital reconstructive surgery immediately after birth. They go throughout life never knowing who they are and need medical treatment and counseling to cope with normal day-to-day living. Even after being told about their anatomy as an infant, many of the intersexed people still feel as though they are “freaks” their doctors and parents saw them as abnormal after being born. They go on to resent their parents and doctors not only for withholding the truth of their condition but also for seeing them as a problem that needed to be fixed. Martin Malin, a professor in clinical sexology, has found this to be a persistent theme running through intersexuals medical experience:

As I listened to [intersexuals’] stories, certain legit motifs began to emerge from the bits of their histories. They or their parents had little, if any, counseling. They thought they were the only ones who felt as they did. Many had asked to meet other patients whose medical histories were similar to their own, but they were stonewalled. They recognized themselves in published case histories, but when they sought medical records, were told they could not be located…. The patients I was encountering were not those whose surgeries resulted from life-threatening or seriously debilitating medical conditions. Rather, they had such diagnoses as “micropenis” or “clitoral hypertrophy.” These were patients who were told-when they were told anything-that they had vaginoplasties or clitorectomies because of the serious psychological consequences they would have suffered if surgery had not been done. But the surgeries had been performed-and they were reporting longstanding psychological distress. They were certain that they would rather have had the “abnormal” genitals they [had] had than the “mutilated” genitals they were given. They were hostile and often vengeful towards the professionals who had been responsible for their care and sometimes, by transference, towards me. They were furious that they had been lied to.

Among imposing on their human rights, sex assignment surgery before an intersexed individual has reached puberty and has given consent is purely unethical. Physicians need to take the necessary steps to help the patients and the parents of intersexed children cope with their condition in society, not keep it hidden from the world and their patients. This no longer should be considered a medical problem, but a way of life.

Work Cited
Dreger, Alice D. “Ambiguous Sex.” Intersex Society of North America. June 1998. 16 Mar. 2008

Dr. Alice Dreger writes the kind of treatments used by intersexed individuals and how they affect them in adulthood.

“Gender Assignment Surgery Vs. Surgery in “Nature”” Intersex Initiative. 06 Feb. 2004. 15 Mar. 2008

This website uses the book “The Most Important Sexual Organ” By Dennis C. to prove the point that in most cases sexual identity is not based on what organs you have. The article goes on to say that in most situations sex reassignment surgery is wrong and the patients get assigned the wrong gender.

Lehrman, S., comp. Going Beyong the X and Y. Gloucester County College. 15 Mar. 2008

This article, from Ebsco Host, gives information on certain cases of intersexed people. It uses information by Eric Vilain, a doctor, that intersexed people are not a problem. They should be treated like normal human beings, even without surgery.

Smith, Susan L. “Lampert Smith: Orchid Ladies Test Gender Perception.” Wisconsin State Journal (2007): 1-3. 16 Mar. 2008

This journal article found online is the interview between a girl who found out she was born intersexed and Oprah Winfrey on her talk-show in September of 2007.

The Contributions of John Money: A Personal View. By: Bullough, Vern L. Journal of Sex Reasearch, Aug 3003, Vol. 40 Issue 3, p 230-236, 7p Abstract.

This article in a journal uses John Money’s theory that sex reassignment surgery may be necessary for an intersexed person to lead a normal life. It often quotes Dr. Alice Dreger, a supporter of the idea that the children should give consent in their later years of life before any major surgery is performed.

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