Should doctors be allowed to continue performing cosmetic operations on intersex infants?

No

1 of 7

by Blind Ambition

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Intersex doesn't really have one solid definition. The medical community is nice enough to leave it out of the books and is opting for something called Disorders of Sexual Development (DSD). While this has it's issues, I'll leave it for now.

The Intersex Society of North America (ISNA - www.isna.org) provides a pretty good definition, which I'll borrow:
"Intersex" is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn't seem to fit the typical definitions of female or male. For example, a person might be born appearing to be female on the outside, but having mostly male-typical anatomy on the inside. Or a person may be born with genitals that seem to be in-between the usual male and female types-for example, a [person with XX genotype] may be born with a noticeably large clitoris, or lacking a vaginal opening, or a [person with XY genotype] may be born with a notably small penis, or with a scrotum that is divided so that it has formed more like labia. Or a person may be born with mosaic genetics, so that some of [hir] cells have XX chromosomes and some of them have XY."

The ISNA also provides brief descriptions of some of the different things that could cause an infant to be labeled as intersex. It's important to remember that intersex is an umbrella term that can cover a multitude of different body types and experiences.

Often times, intersex conditions are defined as people having ambiguous genitalia. This is simply untrue, many people with intersex conditions have primary sex characteristics just like any person without an intersex condition. Genitals are, however, often the first focus of parents and doctors.

The medical community and intersex:
There is no (to my knowledge) established guideline for doctors to follow if they are faced with an infant whose genitals don't fit into their decided definitions of male or female. In the past, the unofficial policy has been to perform surgery to give the infant better recognizably male or female genitals. Often times these surgeries are performed very early in the infants life. Genital surgeries may also be performed on children once they start reaching puberty, since not all intersex conditions are noticeable at birth.

With infants, the doctor's past practice has been to inform the parents that their son or daughter is perfectly fine, they just need to perform a small surgery to fix their penis or clitoris or vagina so that it is "normal". Doctors would intentionally mislead parents by essentially choosing which sex the child would be based on cultural ideas of male and female. An infant was male if ze would be able to pee standing up. We think of sex and gender in terms of sex being scientific and gender being cultural and social. Here we see how these categories overlap, where the mundaneness of standing to pee somehow decides an infants sex, and therefore what type of surgery the doctor plans to perform. Sexism also enters into decision making, one doctor boasts the infamous quote of, "It's easier to dig a hole that build a pole." The idea that a penis must look a very particular way while what a "normal" infant vagina looks like is fairly undocumented. The truth is that a)penis size at birth has no correlation with adult penis size b)many infants are assigned female because of the exactness of the look a penis and the idea of the relative simplicity in constructing a vagina c) no one has really done extensive research on what the average infant penis or vagina looks like, so many doctors are relying on their own cultural ideas to make these decisions. It is also important to note that parents were presented with an idea of urgency. They were not provided with resources so that they might learn about alternative options for their infant. They were not given the numbers of support groups, nor told the statistics on how many infants are born with intersex conditions, they were often not made fully aware, and the doctors pressed to perform the surgeries quickly.

Beyond this, many adults who in infancy had had genital operations were not made aware of their condition. The information was actively hidden from them at times, even when they were at an age to see their medical records. Too, doctors would not always diagnose the condition which could have caused them to develop differently to begin with. Many genetic disorders carry with them effects beyond the appearance of genitals. Doctors focused on removing what they saw to be the real problem - genitals which don't match our norms - instead of curing their patients needs and helping them with conditions that can cause possible disability.

The surgeries themselves were done "for the benefit of the child". It was thought that parents wouldn't be able to love their child if every time they changed their diaper they were faced with their child's neither typically male or female genitals. Parents and doctors alike claimed that a child would be extremely harmed growing up with genitals that look like everyone else's. The problems with these ideologies is very clear. If a parent can love their child after months of diaper changes, genitals really aren't going to change that. And young children have no idea what they are "supposed" to look like "down there". There was less concern (especially in the case of assigned females) for sexual sensitivity. So long as a normal sized penis would fit into hir vagina, the doctors thought they had done their job. Success was also meant, of course, that the child identified as heterosexual.

These practices do continue to this day, although the field is changing. More doctors are being made aware of adult patients who would have preferred to remain un-cut in infancy. There are more visible support groups, some of the stigma has lifted, parents have more resources available to them, and more people are starting to hear the rights claims, especially as some intersex activist have begun appealing to groups that opposed female genital mutilation and have adopted the term infant genital mutilation in reference to surgeries on intersex infants.

Being intersex doesn't mean someone has a gender problem. Most people with an intersex condition identify as either male or female. Some do identify as trans or third gender (or simply intersex), but they aren't natural allies and despite provoking conversations about sex, gender, and surgery (as well as a history of medical abuse and stigmatization) they shouldn't be confused or thought of as in the same vein.

Emi Koyama has an incredible website called Intersex Initiative with more information, at www.intersexinitiati ve.com.

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