The woman giving
the presentation at the front of the room is as curvy as
can be. So imagine my surprise when she reveals that she has
XY chromosomes and has not had surgery to create those
curves! And yet, she did have surgery at birth to
remove her undescended testes, long before she was
capable of authorizing the surgery. What in the world is
going on here?
Welcome to the
world of intersex people. The Intersex Society of North
America (www.isna.org) describes an intersex condition as
being "born with an anatomy that someone
decided is not standard male or female." Many
intersex people have "normalizing" surgeries
imposed on them when they are too young to grant
permission, and then spend the rest of their lives
struggling to heal from those surgeries.
In that struggle
they often encounter issues based upon their gender
identity and gender expression, and those struggles
sometimes result in intersex people being included
under the transgender umbrella. Whether or not that is
appropriate, their situation is certainly worth a few words.
(And if you ever see "LGBTI," this is the I.)
There are many
different types of intersex conditions. These conditions
can result in women without ovaries, clitorises, and/or
inner labia, and men without testes. They include
people whose genitals are ambiguous, and people with
chromosomes that are neither XX nor XY. And they include any
baby with testicles whose penis is too short, and any baby
without testicles whose clitoris is too large.
Feminist
biologist Anne Fausto-Sterling has estimated that 1 or 2 in
1,000 have surgery to "normalize" genital
appearance long before the children understand what is
going on. Parents authorize the surgeries, desperate
to avoid the "shame" of a child who does not
conform to the gender binary, and the medical
profession is only too happy to comply. Parents are
then instructed to socialize the child as the gender that
the child was made into, which, as you might guess, is
disproportionately female. Parents are told to never
tell the child about the surgery. Call it "Spin
Control, Home Edition."
This flawed
treatment protocol is based largely on work done at Johns
Hopkins University in the 1950s and 1960s that purported to
show nurture was more important than nature in raising
a child. We have since learned that people have a very
strong perception of the gender they are--their
"gender identity"--regardless of their
upbringing. And a high-profile case that initially
served as support for the Hopkins work--of a boy
raised as a girl after a botched
circumcision--later took a dramatic turn to make it
convincing evidence to the contrary.
The story of
David Reimer is documented in John Colapinto's recent
biography As Nature Made Him. All the while that
David was being referred to as a success story by
psychologist John Money at Johns Hopkins, David was
clearly uncomfortable living as a girl and was
refusing the recommended subsequent surgery to create a
vagina. When David learned the truth about his botched
circumcision at age 14, he quickly transitioned to
live as a boy.
A 2004 study,
conducted by another scientist at Johns Hopkins and
published in The New England Journal of Medicine,
offered more proof to the contrary. The study followed
16 cases of children who were genetically and
hormonally male but were born with a very small or absent
penis. Of the 16, 14 were given female hormones and raised
as girls. Years later, researchers found all 16 to be
behaving as boys no matter how they were raised, with
eight of them now declaring themselves male.
What causes
intersexuality? It's often just the normal course of
nature---there's much more gender and sex
diversity in the human species than we were taught in
school. But there is also evidence showing that
exposure to certain chemicals while in utero can alter
physical and genetic sex. Deborah Rudacille explores
this possibility at length in her excellent book
The Riddle of Gender. In one example she cites
the surprising tendency of the sons of moms who took
the synthetic estrogen supplement DES during pregnancy
to have intersex conditions.
Intersex people
who ultimately learn (and most do) that they underwent
"normalizing" surgeries are left to feel as if
they are anything but normal as a result. They feel
rejected as the people they were at birth. They are
also hindered in developing intimate relationships because
the surgeries usually damage sexual sensation. And
should the gender imposed on them in their early years
turn out to be the wrong one, they often feel no
choice but to undergo a gender transition to undo a choice
that their parents and the medical community made for
them.
Yes, intersex
people show us a compelling example of how a strict,
unwavering adherence to the gender binary can cause far more
damage than good.