Posts tagged Intersex
Posts tagged Intersex
When M.C. was born eight years ago, the newborn was not easily identifiable as a male or female.
When M.C. was just 16 months old and in the care of the South Carolina Department of Social Services, doctors and department officials decided the child should undergo sex assignment surgery to make M.C. a girl. There was no medical reason to perform this surgery, which robbed M.C. not only of his healthy genital tissue but also of the opportunity to decide what should happen to his own body.
Now 8 years old, M.C. identifies as a boy – wearing boy clothes and hairstyles – despite an irreversible surgery that has left him with female genitalia. He has announced to his school and his religious community that he has always been a boy.
The Southern Poverty Law Center filed a groundbreaking lawsuit today on behalf of M.C.’s adoptive parents, Mark and Pam Crawford. It charges that the state of South Carolina violated M.C.’s constitutional rights when doctors surgically removed his phallus while he was in foster care, potentially sterilizing him and greatly reducing, if not eliminating, his sexual function.
It also charges that the doctors committed medical malpractice by failing to obtain adequate informed consent before proceeding. The defendants told M.C.’s guardians to allow the sex assignment surgery but did not provide information regarding the surgery’s catastrophic risks, including sterilization and greatly reduced or wholly eliminated sexual function. Most important, they did not tell them that the procedure was medically unnecessary.
Today’s lawsuit is the first of its kind to be filed in the United States.
incredible. how long is the statute of limitations on medical malpractice? i was operated on without my consent when i was born, again nearly two decades ago, and then chemically transitioned in the wrong direction and i just. AGH. why was it ok for doctors to make this choice for me as a child, that as an ADULT i’m unable to make due to massive institutional discrimination? i know what i want and i’m gonna keep blogging about it until i get it…
From OII Australia:
Issue 1: An end to non-consensual infant genital surgery
- OII opposes all cosmetic (non-essential) surgery on infants without their full and informed participation in decision-making and their agreement.
- There is no solid evidence that infants are advantaged by genital surgery and absolutely no long-term follow up research – long-term being more than ten years past puberty. To the contrary, recent research shows infants fare as well if not better without surgery.
Issue 2: Inflexible medical protocols and paradigms
- FOR example, individuals with XXY chromosomes are always regarded as male according to existing medical paradigms. This means XXY women or those who are neither male nor female have difficulty accessing medications and medical treatments appropriate to their sex and/or gender and that their intersex differences are only recognized so long as they conform to sex binary expectations. Individuals who do not conform to these expectations are relabeled as transsexual. [Author: Other examples for AIS, CAH, XO etc can be given.]
- FINDING papers on XXY women is nearly impossible because the world wide medical paradigm is that such individuals are always men. OII Australia has several XXY women as members and several XXY people who are neither male nor female, thus putting the lie to the paradigm. Professor Milton Diamond from the University of Hawai’i is aware of the problem.
- THERE are no treatment protocols for XXY women or AIS men.
Issue 3: The need for access to appropriate medication
- WHERE an individual presents in ways not expected by standard diagnostic paradigms access to sex and/or gender appropriate medication can be problematic. For example, XX CAH men are treated as women and cannot access testosterone or male appropriate drugs unless they are prepared to enter into transsexual standards of care.
- SOME intersex individuals who need androgen suppressors are forced to enlist on a potential sex offenders registry held by the Therapeutic Goods Administration (TGA) to qualify.
- WHERE protocols do exist and the individual falls within expectations for that protocol medications are not tailored to individual needs. The difficulties experienced by XXY men with testosterone both in terms of type and dosage are legion. Satisfactory doses of estrogen and testosterone combinations are usually arrived at by personal experimentation using off label prescription and privately sourced supplies.
- MANY of the most appropriate medications, particularly hormones, are not approved by the Australian Therapeutic Goods Administration (TGA) so are not available on the PBS (Pharmaceutical Benefits Scheme). The TGA has limited options for hormone treatments for intersex so that some individuals are forced to import drugs at their own expense and at some risk. TGA rules make it very difficult for intersex to get the best drugs for their needs and to take those drugs into and out of the country.
Issue 4: Lack of clinical research and evidence to support medical protocols and paradigms
- THERE is no substantive evidence for numbers of intersex of what constitutes outcomes, good or bad, for intersex in the long term and no agreement on what constitutes intersex or DSDs. Below are some articles that explore these issues. Anne Fausto-Sterling has produced the only comprehensive study on intersex numbers ever undertaken.
Issue 5: The need for client-centered evidence-based medicine for intersex
- INTERSEX people have physical differences of anatomy that are not completely understood by science. Intersex differences are extremely diverse and even within specific diagnosis groups there are significant differences between individuals.
- CAH for example has three main types. In the most common, 21 hydroxyls deficiency, there are ten main genetic differences from the fifty that are so far known. To complicate matters there is no XY CAH intersex reported in the literature. Many XX CAH have functioning female reproductive parts and give birth to children as female. Such individuals are considered to have a DSD by medicine however are not intersex either in their own minds or by anatomy.
- IF intersex is to be properly treated then individual circumstances such as sex and/or gender, reaction to medication, kinds of medications and surgeries needed have to be catered for.
- NARROW diagnostic paradigms based on limited research forcing people, despite their variations from expected standards, into unsuitable treatment programs are not acceptable.
Issue 6: The need to radically reassess the mental health needs of intersex
- INTERSEX who reject their birth assignment of male or female and who go on to live in either an opposite sex role or no sex role are currently deemed to be suffering from a mental illness. This places the responsibility for mistaken birth assignments with the victim and not the perpetrator. Successful legal cases have been brought in several countries against doctors on the basis of forced sexing of a child. David Reimer and Christiane V are two celebrated examples.
- THERE is a desperate need for medicine, psychiatrists and psychologists especially to stop seeing sex diversity such as intersex as being the cause of mental illness. This attitude harks back to the bad old days when variation in sexual orientation was seen as sickness.
- INTERSEX rejection of birth assignments, sexual orientation, gender (or genderless) presentation is not the issue and seldom has been. Intersex people suffer high rates of mental illness because of bigotry and marginalization. Intersex people struggle because they are seen as unacceptable unless the they comply with sex and gender binary roles and modify their bodies to conform to those roles. The strongest and most frequently repeated messages that intersex people are given in most cultures is that they are “unacceptable”, “freaks” or “weird.”
- THE primary message for intersex who have been surgically altered as infants, who have hormones and other “normalizing” treatments foisted on them as adolescents, who are told of their need to commit to normalizing treatment programs as adults, is that their bodies are sick, disordered, that they are in need of a cure. Poor mental health outcomes arise directly from this.
btw if anyone wants access to full text stuff on here, let me know and I can try to find them via my university
This is absolutely false, and I am growing very tired of refuting it again and again and again. The term “Coercively Assigned X At Birth” was coined by the trans community as a replacement for “Male to Female” and “Female to Male” which is both inclusive of nonbinary trans people and emphasizes that a trans person is not defined by their birth assignment. It was not coined by the intersex community and then appropriated by the trans community — and I would know, because I happen to be both trans and intersex, and active in both communities since my early teens.
“Coercively Assigned” terminology was not used within the intersex community to any appreciable extent until after it was firmly established in the trans community and had started spreading into the wider LGBTI community through trans activism. It was only at that point that certain intersex activists — those who were active within the queer community — began to cross-adopt it in the context of acknowledging the connections between trans and intersex. The claim that trans people “stole” the term is revisionist bullshit originating intersex activists who liked the term but opposed solidarity with trans people.(via freedominwickedness)
Children’s lives lie at the center of social struggles over trans gender and intersex issues. If you talk with trans and intersex adults about the pain they’ve faced, the same issue comes up over and over again, from mirror-image perspectives: that of medical interventions into the sexed body of the child. Intersex and trans adults are often despairing over not having had a say as children over what their sexes should be, and how doctors should intervene. Meanwhile, transphobes and the mainstream backers of intersex “corrective” surgery also focus on medical intervention into children’s bodies. They frame interventions into the sexual characteristics of intersex children as heroic and interventions into the bodies of trans children as horrific.
The terms and claims that get tossed around in these debates are very dramatic. Mutilation. Suicide. Chemical castration. Forced sex changes.
We need to understand what’s going on here, because it’s the central ethical issue around which debates about intersex and trans bodies swirl. The issue here is the question of self-determination, of autonomy. Bodily autonomy is the shared rallying cry of trans and intersex activists, though we might employ it in opposite ways. Refusing it to us is framed as somehow in our best interests by our opponents.
In this post we will look at how four groups frame the issue: intersex people, trans people, the mainstream medical professionals who treat intersex people, and opponents of trans rights.
Sex is not as simple as you think.
Not that any cis people care. They still pretend they have magical chromosome-sensing powers.
The “butbutbut chromosomes!” argument is so hilariously circular, anyway. They say that I’m “male” because I’m XY, and they know that I’m XY because I’m “male”. lol. Logic fail.
But, of course, trying to argue the science with them doesn’t help much, because the science was never the point. What they’re doing is taking their deeply-held beliefs about gender — namely, that there are male and female “essences”, and that what you are assigned at birth is What You Are, forever and ever, amen — and couching them in a scientific veneer. Posts like this are useful, in that they help those who do care about the science to explode some myths and understand what’s really going on, but I wish I knew of a way to reach the really hardcore bigots. :(
I considered posting sections of this book, but the entire thing is so informative and groundbreaking (in the sense that most legal scholars don’t actually evaluate the effects of cultural bias or systemic oppression in cases of injury, or torts).
The chapter it directly links to, Regulating Middlesex, gives an insightful and relatively easy to digest introduction to forced gender assignment in the cases of children and adolescents who are classified as intersex or whose bodies do not fit the cultural demand for a gender binary classification system. As someone who underwent several of these operations and ordeals myself, it is terribly upsetting and I wouldn’t recommend it if you’re looking to read something that isn’t going to ruin your day.
Well.. if you’re a decent human being, I suppose.
Trimmed off the part where the chapter is embedded; if you want to see it, check it out in reinventionoftheprintingpress’s OP. I’m reading it.
Nonconsensual surgery on infants (intersex infants specifically) and genital essentialism are the most obvious.
“For medical experts, the appearance of external genitalia tends to be considered more important than chromosomes in determining sexual identity. Current medical protocols, for example, indicate that newborn boys should have a penis that is at least 2.5 centimeters long and newborn girls should have a clitoris that is no larger than 1 centimeter (Ben-Asher, 2006). Children who do not conform to these norms are designated for medical treatment, including hormone therapy and surgery, to help them more closely approximate the traits of either a male or female classification. Although ambiguous genitalia pose no physical health risk, the birth of a child with ambiguous genitalia is deemed by medical experts to be a “social emergency” requiring immediate medical attention (American Association of Pediatrics [AAP] Policy, 2000). As a practical matter, it is much easier to construct an artificial vagina than an artificial penis. Because of this, it remains standard practice within the medical profession to perform a sex change operation on children with unusually small penises and other “under-masculinized” traits, even if the chromosomes fit the XY classification as male. XX babies with enlarged clitorises, on the other hand, are not converted into “boys” but undergo surgery to either remove or alter the clitoris to conform to medical expectations for girls.”
— Regulating Middlesex by Anne Bloom, found in the anthology Fault Lines, edited by David M. Engel and Michael McCann
I have no idea.
(Also, yay for the Inter/Act shoutout!)
My daughter was not of woman born. That is a concept that has fascinated people through the ages. My daughter’s gestation was perfectly “natural,” I should point out—but I carried her, and I was never of the female sex; I am a so-called “true hermaphrodite.” I was assigned female at birth, and was living as such when I gave birth to her, but I never identified as a woman, and am now legally male. A lot of myths circulate around the topic of intersex fertility, many of them perpetuated by doctors. They all relate to the current Western insistence on the ideology of sex dyadism. That ideology holds that there are two and only two sexes, and that this is required by “nature” in order to perpetuate the human species.
In fact, sex is a spectrum (see here and here for more information). About one in 200 people has some intersex characteristic. However, in contemporary Western society we are hidden away, medically “corrected,” erased. And often this erasure is bound up in rhetoric about fertility. One way in which medical textbooks frame intersex people as “tragic” is by presenting us as usually infertile. I’m not going to spend time critiquing the idea that a person must procreate to be a fully mature and valid adult, though I certainly don’t believe that to be true. What I want to address from an intersex perspective is the fact that many of us are capable of reproducing.
Intersex Roadshow is a quality blog.