Why Surgical Sex “Correction” of Intersex Babies Is Genital Mutilation

3 04 2009

The socialized gender binary is imposed on us starting when the doctor exclaims “It’s a boy/girl!”  But the sex binary (as opposed to the more fluid self-defined experience of gender) is generally thought to be relatively concrete, less socialized, and more biological.  The births of children with ambiguous or abnormal genitalia are therefore most often a huge shock to both the child’s parents and to physicians.

Although reactions to intersex people vary between cultures, our American social system seems to leave little to no room for ambiguity.  A child must fall into one of two categories, and if he/she does not, surgery and hormone therapy are generally seen as necessities, not as options.  Assumptions about the progressive nature of science and the omniscience of physicians combine with prejudices about social acceptance and the perceived importance of heterosexual penetrative sex to drive a disturbing pattern of genital surgeries for intersexed infants, far too young to provide consent. 

How are intersex babies categorized into the sex binary, even though their genitalia may be ambiguous?  One excellent book on the subject is called Sexing The Body by Anne Fausto-Sterling.  In the book, Fausto-Sterling explains that genetic (XX) females are usually kept female at all costs, preserving their ability for reproduction.  Males, however, are usually not classified based on their genetic identity, but rather the size of their penises.  This type of thought is evidenced in the typical treatment of children with Congenital Adrenal Hyperplasia (CAH) as compared with those children with Androgen Insensitivity Syndrome (AIS).  CAH children are XX but are born with or develop masculinized genitalia and can become physically masculinized at puberty.  AIS patients are XY, but are born with feminized genitalia.  At puberty, these children can become feminized in body shape.  These two seemingly opposite “disorders” do not typically have opposite medical treatments.  Both types of children are typically initially classified as female. 

To be fair, studies have shown that most AIS patients tend to later develop a female gender identity despite their XY genetic makeup.  However, we cannot know whether our decision to raise these children as female affected their gender identity.  Generalizing these findings to a decision to classify AIS children as female is highly problematic.  The decision to categorize intersex children as female often has quite a bit to do with penis size.  If a male child cannot stand up to pee, the child is not considered to be adequately male.

Potential For Penetrative Sex

One major assumption governing decisions about the “sexing” of intersex babies regards the ability to engage in penetrative heterosexual sexual activity.  The penis must be large enough for penetration; the vagina mustn’t be too large or too small.  The clitoris most certainly cannot be too large, lest its unsightliness or resemblance to a penis cause confusion or disgust!  Little regard is paid to pleasure, as intersex child’s genitals are snipped, clipped, and remolded to look and function in a way consistent with heterosexual penetrative norms.  Scarring and sensitivity from “corrective” surgeries can take away these people’s potential for sexual pleasure.

Clitoral reduction and recession are particularly disturbing, especially when many of us have just begun to realize the fallacy of the myth of the vaginal orgasm.  Still, intersex babies assigned as girls have their clitorises cut and tucked, often purely for cosmetic purposes.  Society dictates that girls must look and act like girls, even down to their most intimate areas.  It is assumed that a penis should look like the ideal penis, and a clitoris should by no means resemble a penis.  Physicians routinely alter the size of intersex vaginas and clip intersex and non-intersex babies’ clitorises in the name of necessity, thus implicitly throwing female pleasure out the window and giving precedence to penetrative sex.  A successful intersexual is a “heterosexual,” that is a person whose sexuality matches with what is deemed appropriate for his/her gender assignment.

Science and Medicine

Science and medicine have brought countless advancements, but it seems that often there is an over-reliance on medicine and science as un-objectionable fact.  We are taught to trust our doctors and other “experts,” but this blind trust could be extremely damaging in cases of intersexual surgery.  Parents of intersexual children may not consider the physicians’ biases, seeing the doctors as infallible.  The doctors, on the other hand, are equally as eager to do what they see as right, and to send the parents away with a sure-sex baby.  Families are thus often swayed by a surgeon’s advice without being given the chance to properly consider potential outcomes of their decision and without being able to talk to families and individuals who have been faced with similar decisions.

Studies again and again refute each other in attempts to prove biological differences between the two sexes.  Very few of us have ever considered that these two sexes may not be as different as we think.  Even fewer have considered that the two sexes or genders may not just be two in number.

The discovery of hormones has been one of the most fascinating discoveries in science and medicine.  Hormones suggest a biological basis for gendered behavior and even sexual preference, and the use of hormone therapy can influence one’s appearance, physical traits, behavior, and perhaps even desires.  But it is also important not to discount societal influences or, even worse, assume that hormone therapy is a sure-fire “fix” to a masculine female or feminine male.  And why on earth do we need a “fix” anyway?

Social Acceptance

A sincere belief in the necessity of social acceptance motivates any decision to operate on an intersexed child.  Not only the social acceptance of the child is at stake, but the pride of the entire family.  “Pink or blue?”  The potential embarrassment of having an ambiguous youngster must be extremely frightening to the parents.  Discrimination would affect not only the child, but the entire family.  It is most likely easiest to make a decision as to the sex of the baby as quickly as they can, and avoid as much social discomfort as possible.  And since it is often assumed that until a certain age, the parent’s opinion is the same as the child’s, it is often not considered that the child’s right to choose is being co-opted.

The parents and doctors are of course motivated by a genuine concern for the child’s welfare.  In the classroom, the locker room, and even in the work world, there is no room for ambiguity.  Social expectations define gender, and we assume the necessity of a clear gender identity for a happy life.  All too often, if the child fulfills expected gender roles, then the “corrective” surgery is deemed to have been successful.  Our society teaches us to believe that ambiguity is a lack of identity.  There is typically no thought given to the fact that ambiguity may actually be part of an identity.  Most people, when confronted with the suggestion that there may be infinite genders, or even infinite sexes, are completely taken aback.  Intersexuality doesn’t have to be seen as a disorder afflicting normal males and females.  Intersexuality could simply be more variation on the infinite varieties of people.  

But raising an intersex child as a “third gender” might just not be practical or fair in our current social system.  The Intersex Society of North America asserts that:

• Intersexuality is primarily a problem of stigma and trauma, not gender.
• The child is the patient, not the parents.
• Professional mental health care is essential.
• Honest, complete disclosure is good medicine.
• All children should be assigned as male or female, without surgery.

Why not raise intersex babies in a “third gender?”  Well, ISNA argues that in fact most intersex children do grow up to identify as male or female, and relatively few identify in adulthood as a third gender or gender queer.  And ISNA believes that raising intersex children in a “third gender” would just further stigmatize these children and set them apart as “abnormal.”  ISNA argues that children should be given hormonal, genetic, and radiological tests as infants to determine the most likely gender that they will identify as as adults.  ISNA argues that these children should be raised in the most likely gender assignment, and then should make the decision as to whether to obtain surgery when they are of age and fully informed about the risks of surgery and their own gender identity.  ISNA states:

In cases of intersex, doctors and parents need to recognize, however, that gender assignment of infants with intersex conditions as boy or girl, as with assignment of any infant, is preliminary. Any child—intersex or not—may decide later in life that she or he was given the wrong gender assignment; but children with certain intersex conditions have significantly higher rates of gender transition than the general population, with or without treatment.

But whereas incorrect gender-assignment of intersex babies is a concern, incorrect surgical “correction” of intersex babies is downright terrifying.  In my opinion, it is crucial for patients to make informed decisions as to their gender identity and desired genitalia when they are able to voice their own opinion about their bodies (NOT when they are newborns).

If a boy cannot pee standing up, does that make him less of a boy?  If a woman’s clitoris is enlarged, has her womanhood been diminished?  How de we define womanhood, anyway?  These questions are imperative to the treatment of intersexed people.  I realize that many people might disagree with me that infant intersex genital surgery is genital mutilation.  But surgery on another’s genitals without their agreement is in fact abuse.  It is critical to recognize the difference between when surgery is actually necessary for intersexed people for health reasons and when the surgery is cosmetic.  We need a more fluid understanding of gender.  I hold a firm belief that there are as many genders as there are people.  (We are ALL to some extent, Gender Blenders“Normality” cannot be defined.  The very attempt at definition holds us back from individuality.

In some of these situations, operations are necessary for the health of the child.  But intersexed children should not be operated on unnecessarily until they reach an age at which they can choose for themselves, at which time they should be provided support and connections with other intersexed people and their families.  They must be made aware of the risks, and also must be celebrated for their own beauty and uniqueness.  Science and society define intersexed bodies as mistakes, imperfect versions of a true male or female.  In a society in which gender and sex are so rigidly defined, it will always be a struggle for anyone who deviates from what is seen as the norm.  But, our society cannot change without our help.  We must stop putting penetrative sex ahead of pleasure, putting cosmetics ahead of choice, and putting science ahead of compassion.  





Transphobia, Sexism, Fatism, Ageism, and Bullshit All Rolled Into One Hideous Advertisement

3 04 2009

dasl-drunk-woman_thumb

This is old news, but I found the ad so offensive that i felt compelled to post it anyway.  Apparently the creators of the ad find excessive drinking to be extremely repulsive, but of course only for women.  Why?  Because drinking excessively is drinking “like a man.”  And the ad relies on attempting to provoke disgust by displaying a masculine-looking face with makeup and female attire.  A trans woman in the town where the ad was distributed has filed a complaint about the ad, and asked for its removal.  However, NHS claimed that the posters had been effective in reducing excess drinking in women, and saw no reason to remove the ads.  The creators of the ad  insist that they made the ad in conjunction with the “national lead for the transgender community,” and that the ad is not transphobic or problematic.

There are legitimate health risks of excessive drinking, both for women AND men.  But this ad doesn’t even make it clear that excessive drinking is the problem.  “Wine doesn’t just come with cheese.  For women it is accompanied by hair loss, wrinkles, and obesity, plus other problems like breast cancer, early menopause and memory loss.” By making the ridiculous implication that drinking wine makes women old, obese, and unattractive, the ad plays on misogynistic stereotypes of appropriate female behavior and reinforces cultural ideals of feminine attractiveness.  By displaying a masculine face with makeup as an example of the imminent aging, obesity, and unattractiveness for women who drink excessively, the ad also implies the breaking of socially imposed gender roles is equivalent to a lack of attractiveness.  It’s pretty disgusting that an organization that is intended to promote public health could create an ad that is so offensive and harmful in so many ways.





We aren’t exactly closing the gap …

3 04 2009

The April 2nd edition of the Tufts Daily included an article entitled “Women closing in on employment gap.”  When I first saw the article title, I frowned; I was aware of how the recession was affecting unemployment rates for men and women, but I hadn’t heard that the employment gap itself was actually closing.  After reading further, I was pleased to note that the article did address other issues relating to sex and employment:

According to the economic consulting firm IHS Global Insight, employers in the health care and education sectors added 536,000 jobs in 2008. These are sectors where women are more likely to work. Simultaneously, manufacturing and construction — sectors that are overwhelmingly male — showed a sharp decline in job opportunities last year.

Also significant is the number of women working part-time: Part-time jobs are much more secure in a job market where cutting hours is a popular strategy. Because many more women work part-time than men do, their jobs appear much more secure.

This information is accurate, but what I find troublesome is the failure to problematize this information.  Yes, there are significant numbers of women working in health care and in education.  But many women working in health care are nurses and social workers, and many women working in education teach lower levels of education (pre-school, elementary school, and middle school).  In addition, as you look higher up on the job ladder, you find more and more men; there are significant numbers of male principals and superintendents, as well as male chiefs of medicine and board members.  Women in medicine also tend to work in family practice, pediatrics, or gynecology, some of the lower paying medical specialties.

In addition, it isn’t appropriate to compare part-time jobs to full-time jobs; many part-time jobs don’t have the same benefits that full-time jobs do, and even some that do only give them to employees who meet specific requirements.

We are seeing the employment gap narrow in a very specific way right now, and not in a way that is truly beneficial for people, or a way that reflects a change in social attitudes or norms.  Women aren’t being hired more because employers are learning to shed biases; women are being fired less because they work part-time more and tend to work in fields that are less drastically affected by the recession.  These jobs still pay less than men’s jobs; the wage gap is alive and well.

Therefore, instead of seeing an actual improvement in the economy and the way that women are treated in the workforce, we’re seeing families that have to rely on mothers and wives to be wage-earners even though their jobs tend to pay less and have fewer benefits.

In the final paragraph of the article, the Daily says:

These statistics have instilled optimism in some women’s rights activists hoping for employment equality. Freshman Katie Kopel explained that such excitement should be met with reservations. “[The closing gender gap] should not be misinterpreted as a sign that women are treated equally in the hiring process or the workplace.”

I’m with Miss Kopel; this isn’t what many of us were looking for when we wanted the employment gap gone.  Kopel has very concisely summarized two huge issues facing women and employment today: many women aren’t hired because of biases against women, and many women are harassed and treated unfairly in the workplace itself.  In addition, as I said earlier, the wage gap is still approximately 71 cents to the dollar on average for women.

While I am very happy that the Daily reported on this issue, and that they recognized many of the reasons why unemployment for men and women is so different during this recession, I am frustrated with the amount of positive spin that the article gives this issue.  Yes, I want to see men and women hired equally, paid equally, and treated equally, but to do that, we need to see a shift in societal attitudes.  I wonder what will happen when the recession ends; will it be like the end of WWII, when the men came back and demanded their jobs?

As one last thought, consider the meaning of “unemployed.”  Are stay-at-home parents employed or not?  What does that really mean in terms of women’s employment nationwide?





We were kicked off the Observer!

3 04 2009

Bad news! Our column next week in the Tufts Observer will be our last. Unfortunately, some managing editors  felt uncomfortable with us writing anonymously.

For those of you who know our identities, we want to strongly stress that it is really important that we remain anonymous. Our last column has caused quite the stir and while we are excited to facilitate discussion, we still feel that tying our names to the authorship could obscure the fact that sexual assault on our campus is something that affects everyone, not just us.

If you agree with us that it is unfair for our column to be removed from the Observer, we encourage you to write to them at observer@tufts.edu.
Thanks in advance for your support!





Are rape jokes ever funny?

3 04 2009

I have been discussing this issue with different people for quite some time now, and I still stand by my belief that rape jokes are never funny.  While humor is a way for some sexual assault or rape survivors to diffuse and normalize their experiences, I don’t think that it’s okay to make rape jokes because you never know who is in your audience and the jokes can be very triggering for some people.  It is not obvious just from appearance who is a survivor of sexual assault or rape.  Whereas other characteristics like race or gender identification may be more apparent and obvious, it is not as easy to tell who has been victimized by sexual violence.

I’ll admit that immediately after my own experience, I joked about it, but that was so people wouldn’t box me in and pity me as that “poor little girl who was just raped”.  And I didn’t want my friends to feel like they couldn’t talk to me about it, that it was “too serious” for them to ask me about or to mention, so I used humor to make it seem like it was more of an approachable issue to discuss.  My joking about my experience or using humor to lessen its impact did not mean that other people felt like they could joke about it too.  Using humor to mock certain aspects of my experience (like making fun of the facebook message my perpetrator sent me the next day that was all “you’re so smart and beautiful, and I’m so smart too and I’d never ever rape anyone”) was a way for me to deal with the trauma that overwhelmed me and was difficult to process.

Later on, after some time had passed and I talked to more people about my experience, other survivors or progressive feminists who were well versed in issues of sexual violence and I would use sarcasm to poke fun at victim-blaming society or to point out the blatantly unfair treatment of sexual violence survivors in society.  The “jokes” we told enabled us to commiserate with each other and shake our heads at a misogynist and flawed system/society that is slanted against survivors of sexual violence.  These “jokes” weren’t told to be funny but to comment on how poorly rape survivors are treated in society.

An earlier post on Jezebel says:

If we take sexual assault off the table of things we can laugh about or joke about, it’s just another way of saying: this is a different crime than any other crime, and so we can and must treat its victims differently than any other crime.

And, you know, fuck that. I got treated differently than any other crime victim once because of the kind of crime that I was the victim of. If I had been mugged, would the cops have been calling my friends and asking them how much I’d been drinking that night? If I had been only robbed, would it have mattered to the cops whether I’d told the guys I was out with that night that I was dating someone? If I had been shot walking out of the bar, would it have been anyone’s business if my friend thought that I was flirting or not? And if any of those crimes had been committed instead, would everyone be so horribly offended by me making jokes about it? It’s all part of the way in which society wants to treat me differently because of how I was victimized. Let’s treat sexual assaults like any other crime and tell some rape jokes. Cool?

While I strongly believe that the legal/justice system’s response to sexual violence as well as societal attitudes and behaviors around sexual violence need to change and survivors need to be treated better, I do not think that telling rape jokes is the way to go.   The reality of the world is that sexual assaults/rapes are categorized and treated as a different kind of crime and survivors of these crimes are treated differently than are victims of other crimes.

I know that there are people who will disagree with me on this matter, and perhaps it will just come down to a difference of opinion, but for me rape jokes are never funny.





Repro Rights Conference

3 04 2009

I am super excited.  I will be at the 2009 Civil Liberties and Public Policy (CLPP) Reproductive Rights Conference: From Abortion Rights to Social Justice: Building the Movement for Reproductive Freedom at Hampshire College this weekend.  Tonight I’ll be at an abortion speak-out for women and tomorrow I’ll be  at workshops all day.  Topics include: Abortion Access Internationally, Abortion Access in the US, Assisted Reproductive Technologies, transgender and genderqueer issues and allyship, the link between Climate Justice and Reproductive Justice, sex work and feminism, how the Right took power, masculinities, the new eugenics, sex positivity, and a lot more of really interesting and engaging topics.  I’ll be back with more after the conference.





Flashback #6

3 04 2009

 

Not sure when this was from, but some time when these comic books were only 15 cents.  

 

Oh no!  They are jarring and pickling sexy half-nude women!

Oh no! They are jarring and pickling sexy half-nude women!

Hmm…they are binding a half-nude woman, forcing her into a jar full of who-knows-what, and adding her to their collection of virtually identical dead skinny naked ladies.  And the cover is implying that SHE is the monster!!???  Vintage sexism at it’s finest, and most disturbing romanticization of sexual violence.  Well done, Marvel Tales.