The unkindest cut.

March 29, 2001 10:01 AM

The unkindest cut. "Standard medical practice dictates that intersex births like Carl's are emergencies that must be 'assigned' male or female and 'corrected' immediately to spare the parents the anguish of uncertainty, with no thought as to what the children would want." Er, wouldn't it be better to wait and see to which sex the child is attracted before slicing him/her to pieces?
posted by frykitty (34 comments total)

"Er, wouldn't it be better to wait and see to
which sex the child is attracted before slicing him/her to pieces?"

uh, why? so he or she can be forced to the international heterosexual standard?
posted by cheesebot at 10:19 AM on March 29, 2001

Er, wouldn't it be better to wait and see to which sex the child is attracted before slicing him/her to pieces?

Well, some would argue that you need to slice the kids to pieces to know what sex they are supposed to be attracted to. To me, it's entirely possible, indeed natural, that a person can be attracted to a member of the same sex.
posted by rschram at 10:23 AM on March 29, 2001

Damn, double-comment!
posted by rschram at 10:23 AM on March 29, 2001

Good point, but you kinda missed mine. What I'm trying to say is that this is tragic--a person should be able to make their own decision about their sexuality.

Being happy as a man being attracted to men is one thing. Being a woman stuck in a man's body because of an arbitrary decision made when you were born is quite another thing. I know I'd be pissed.
posted by frykitty at 10:30 AM on March 29, 2001

Er, wouldn't it be better to wait and see to which sex the child is attracted before slicing him/her to pieces?

Hmmm. I took that to mean "let's wait and see what gender the child identifies with" and let them decide. Though personally, I think it would be really tough for a parent to raise a child in what's considered their formative years. What bathroom do you take them with? How do you know when they choose a gender? Gender is all based on society's socialization of what a male is "supposed" to do and what a "female" is supposed to do. Perhaps it's time to write a new chapter in the Dr. Spock method of raising kids.
posted by bkdelong at 10:32 AM on March 29, 2001

There was a great documentary on TV recently about intersexuals. The most striking thing for me was the anguish of the people whose decision had been made for them when compared to the case of a young person from rural Mexico who was allowed to develop naturally. As a child, she was treated as a girl, but at puberty she became male. He is now happily married. In the interview, his father said, "This sort of thing happens from time to time and we just treat it as a blessing from God."
In the U.S., or in a more developed area of Mexico, the child would probably have been an outcast without being "corrected." Before seeing the documentary, I would have thought the decision a "no brainer" for the parents, but now I'm not as sure.
posted by gimli at 10:36 AM on March 29, 2001

a person should be able to make their own decision about their sexuality.

If you can convince me that you've made your own decision about your sexuality, then I'll buy your argument.
posted by solistrato at 10:36 AM on March 29, 2001

It would be difficult to raise such a child--but not that difficult. Not compared with the anguish of being mis-assigned. If it were my child, I'd prefer the inconvenience to making such an enormous mistake. No matter which sex you choose, you've got a 50/50 chance of being wrong. That's just too high a margin of error.

I also wonder what someone would be like if they'd spent their formative years free from gender judgements.
posted by frykitty at 10:37 AM on March 29, 2001

I also wonder what someone would be like if they'd spent their formative years free from gender judgements.

Well, I don't see that as being possible, not in the U.S. in any event.

I think it would be extremely difficult for a parent to deal with a child like this. I think the best answer is to sort of wait and see but the parents will, unless they live on a commune in the mountains, probably need to decide early on what to call the child -- male or female.
posted by amanda at 10:43 AM on March 29, 2001

Why do they have to make any decision at all that leads to life-altering cosmetic surgeries that aren't medically necessary? I can't believe people think that chopping a child to fit an invented gender, damaging or even removing their ability to enjoy sex or reproduce, is a solution.
posted by rcade at 10:43 AM on March 29, 2001

Solistrato: 'scuse me? I think you're starting an entirely different conversation--please don't nitpick my semantics--you're untintentionally making laughable assumptions about my assumptions.

If a person is intersexed, why shouldn't they be able to choose what sex they will be based upon whom they identify with when they are older? Sure, that's an advantage over the rest of us single-gender schmoes, but so be it. It's the sense of betrayal that comes from another person making that decision that bothers me.
posted by frykitty at 10:45 AM on March 29, 2001

I can't believe people think that chopping a child to fit an invented gender, damaging or even removing their ability to enjoy sex or reproduce, is a solution.

Rcade, I hope you're not referring to my comment. I think that surgically altering a baby in that way is abhorrent. If there was no medical problem associating with the extras going on below then they should be left alone.

I can sympathize with the parents though. It seems like something that would be very confusing. It's not like there's an open history of how to deal with this kind of thing. Homosexuality is still a concept that many, many people just can't grok. This is something even farther outside the norm -- especially outside the norm for a heterosexual married couple, I would imagine.

How would one raise a child like this? What would you tell them? How would you protect them?
posted by amanda at 10:53 AM on March 29, 2001

My comment was made because you seemed to imply that someone could just "choose" their sexual identity, ignoring hormones, genetics, learned conditioning, life experience, emotional trauma, family tensions, psychological fixation and a million other little things that make us attracted to whomever we're attracted to.

And why should they have to choose at all? What's wrong with being a hermaphrodite anyways? A third sex - brilliant! Hell, in alchemy these kids would be ideal.
posted by solistrato at 10:53 AM on March 29, 2001

I think being a genderless (or bigendered I suppose) child would screw you up far more than being assigned the "wrong" gender at birth - I mean, you're now growing up literally different from every single being you'll likely ever meet. And to boot, we're seeing that more and more aspects of personality are determined when very young, meaning the assumption that just leaving things alone is better itself may have far more impact than might first be imagined.
posted by DiplomaticImmunity at 10:56 AM on March 29, 2001

The article talks about how these people were raised one way which made them feel horrible and at some point they switched to the other gender.

Is there no success stories for this type of act? It seems like once in awhile, the docs would get it right, right?
posted by amanda at 10:58 AM on March 29, 2001

I've never understood why these operations are done based on appearance. Why can't they do a chromosome check? XX (girl) vs. XY (boy), regardless of appearance? Most intersexed people have a clear genetic sex, and is almost always the sex the person identifies with. True hermaphrodism is mighty rare, and in those cases all bets are off. I've never seen a documentary or article address this issue, so I'm puzzled. Even this one, in its "Science of..." section just glosses over it.
posted by ewagoner at 11:02 AM on March 29, 2001

Here is a good (but dry) article explaining the various types of intersex conditions and the decision-making process. The compulsion to take quick action comes more from societal pressure than anything else. In a perfect world (rural Mexico?) we could let things play out and spare everyone a whole lot of anguish. In the documentary I referred to above, the people in that village seemed to be the happiest and most well-adjusted.

ewagoner, the article goes into the chromosome check thing, but apparently they take external traits into account more than just XX or XY.
posted by gimli at 11:07 AM on March 29, 2001

From the article:

Although the psychological consequences of these experiences have not been empirically documented, Money and his colleagues suggest that it is wise to avoid the problems of both the micropenis in childhood and the still undersized penis postpuberty by reassigning many of these infants to the female gender. This approach suggests that for Money and his colleagues, chromosomes are less relevant in determining gender than penis size, and that, by implication, "male" is defined not by the genetic condition of having one Y and one X chromosome or by the production of sperm but by the aesthetic condition of having an appropriately sized penis.

That sounds like someone making someone else's decision for them.
posted by gimli at 11:21 AM on March 29, 2001

A chromosome check isn't necessarily the boon it seems to be. What do you do with folks who have extra chromosomes? What do you do with XY people who lack sensitivity to androgenic hormones? Organs, assigned gender, identification, and sexual functioning are not as often in lockstep as we'd like.
posted by jplummer at 11:22 AM on March 29, 2001

Perhaps some of you saw this story on Dateline NBC, which actually re-ran just last week.

In this particular case, the child was not "sexually indeterminate", but clearly male, and the parents were talked into sexual reassignment by a psychologist with an agenda. Still, it speaks to the difficulty of trying to assign gender roles based on external appearance (in this case even aided by hormone therapy).
posted by briank at 11:25 AM on March 29, 2001

Whoops, almost forgot to mention that this is the research of Dr. John Money that is quoted in gimli's post. Big omission on my part, since the patient's actual story totally contraindicated Money's findings.
posted by briank at 11:27 AM on March 29, 2001

Is there no success stories for this type of act?

I'm sure, but how would you know?
posted by kindall at 11:30 AM on March 29, 2001

Is there no success stories for this type of act? It seems like once in awhile, the docs would get it right, right?

I heard an NPR report on intersexed people a year or two ago, and it featured comments from both former hermaphrodites and doctors.

The people who'd been operated on did express a lot of frustration at what had been done to them.

However, they were all adults, and they were talking about surgery from twenty or more years ago. The doctors made the point that surgical and other medical techniques had progressed significantly since then and that the problems the adults reported (lack of genital sensation, etc.) had been substantially eliminated.

I don't know enough about this subject to offer an opinion, and, frankly, I'm unable to put myself in these people's shoes, but it could be that the doctors have a point. It does seem to me that being raised genderless would cause severe problems. It also seems that being raised the wrong gender would cause severe problems.
posted by anapestic at 11:33 AM on March 29, 2001

I was just mulling over what Amanda wrote. The surgeons who perform the procedures seem to be convinced that there is a silent majority who are happy with the result. Many might not know anything was done. If they do know, and they are happy, they are less likely to go public than those who are unhappy.
posted by gimli at 11:40 AM on March 29, 2001

I think being a genderless (or bigendered I suppose) child would screw you up far more than being assigned the "wrong" gender at birth.

From what I understand, that's not been found to be the case. I'm a touch surprised that no one in this thread's yet linked the Intersex Society of North America, whose website is quite refreshingly free from over-the-top rhetoric; especially notable in light of the intimacy of the topic to them.
posted by baylink at 12:04 PM on March 29, 2001

And good catch, BTW; that's the best general-press piece on the situation I've yet read. I *know* it's the best one because it almost made me physically ill; something even *really good* writing very rarely does.
posted by baylink at 12:09 PM on March 29, 2001

Given the limiting and generally unhealthy nature of the gender categories people get stuffed into, being intersexed almost seems like an advantage. Breaking out of "my sex" has been a difficult, ongoing project - to be born outside the system, to design your own gender identity according to what best fits your personality, sounds liberating.

-Mars
posted by Mars Saxman at 12:11 PM on March 29, 2001

It seems pretty clear that these 'corrective' surgeries are being done solely to put at ease the gender insecurities of doctors, parents and society at large - and have very, very little to do with any child's best interests.

The inability to separate gender from sex and both from genitalia (and further, from sexual orientation) is disappointing.
posted by gsh at 12:15 PM on March 29, 2001

If all these intersexed kids get reassigned, then who's going to be left to continue the Hot, Horny Hermaphrodites video series?
posted by MrBaliHai at 2:09 PM on March 29, 2001

It seems pretty clear that these 'corrective' surgeries are being done solely to put at ease the gender insecurities of doctors, parents and society at large - and have very, very little to do with any child's best interests.

One could argue that putting at ease the gender insecurities of securities of doctors, parents, and especially society at large has a lot to do with the child's best interests.

One could, but I won't.
posted by kindall at 3:59 PM on March 29, 2001

There are some places(I believe some rural part of Puerto Rico is one of them), where intersexed births are relatively common(common for genetic mutation, anyway, not like every third kid). The cultures are very accepting, and raise the children as whatever sex they most resemble at the time, and at puberty, one of the genders usually asserts itself. If this involves a change, then everybody goes along with it. If the child was raised as a girl, and puberty leans toward "boy", they basically say, "Okay, you're a boy now," change the name if necessary and move on. Too bad there isn't as much understanding everywhere else. They actually consider the children special.

American Indians consider intesexed persons(berdaches) to be sacred, and highly revere them.
posted by Su at 8:07 PM on March 29, 2001

I wouldn't want doctors to make a decision if I had an intersexed child, but I think I couldn't make the decision myself. Of course, I consider myself an accultured person, I am open to discussing topics and issues that deal with the perception and the experience of sex for the individual, the society, peers and family. I seek for help when I need counseling and am not radical. I would try to raise such a child without preconceptions. I would not be at ease, but I'd do my best.
But intersexed children are born in social environments that are very different from Metafilter and very different from rural Mexico or Porto Rico too. Social environments where moral values are often desumed from the current televised shows. Where sterotypes abound and rule.
I guess my point is: should there be cases when the decision is left to a doctor (it could be a psychologist)? And who'd decides who decides?
Even if parents are unconditionally empowered to decide (this is my personal choiche), there are still going to be many unfortunate sexually misassigned adults. The difference would be that they'd blame their parents instead of society/doctors.
posted by pecus at 1:22 AM on March 30, 2001

To me, parenting has been quite a trial, which it is by definition. If, as part of mothering my child, I had to deal with seeing atypical genitalia every time I changed a diaper, come up with a gender-neutral name, and deal with relatives, friends, and strangers harping about whether my child was a boy or a girl, I'd somehow cope.

It's part of being a parent, dammit - your duty is to protect your child. You're the adult - you are the one who has to pave the way for them to have the best life possible. If that means delaying surgery until the child can have meaningful input as to the condition of their own body, then DEAL WITH IT. (and get your whining about it out of the way early - people with children who have life-threatening diseases, disorders, and injuries would give *anything* to trade places with you).

What makes people think they are entitled to a guarantee of a perfect typical child?

The things that make children differ from one another are often the things that make them so exquisitely wonderful.

Parenting is a pain in the ass no matter what. Parents have a duty to not let the pain in the ass of parenting explode onto the child. After all, the kid didn't ask to be brought into the world...
posted by beth at 8:30 AM on March 30, 2001

Will you marry me, Beth?

:-)

Was *beautiful*...
posted by baylink at 12:32 PM on March 30, 2001