Born Human First: Intersex

Born Human First

When a child is born, they are first introduced by a gender, parents are told they have a girl or a boy. The child is deemed normal and both parents and doctors are satisfied with the result. However, when a child is born that does not fit into either binary category, there is immediate concern and worry. Doctors search for an answer, a solution, so the child can be “normal.” In many cases doctors will turn to surgery. They will permanently alter the child's body for the sake of normality. Genital surgeries performed on infants who are intersex can induce many problems later in life. These surgeries are non-consensual, unnecessary, can cause psychological damage to the individual, and are not always accurate about the child’s

gender which can cause irreversible damage.
Being intersex is when an individual is born with either physical or genetic attributes that fit neither into solely female or male. Physically this can be seen when a child has sex organs of both genders or when the child has any combination of female and male reproductive organs. There are many conditions that fall under disorders of sex development or DSD, which is now a more common term for intersex disorders and about 1 in 2000 children are born each year with a condition that falls underneath the blanket of DSD (James). Genetically these disorders can take many different forms, for instance, partial androgen insensitivity syndrome, or PAIS, is when a person born with XY chromosomes is not affected by testosterone and then has ambiguous or more feminine genitalia. Other disorders like congenital adrenal hyperplasia, CAS, is when a person born with XX chromosomes displays more masculine genitalia (King). There are also individuals who have a mixture of different chromosomes, like Klinefelter's Syndrome, where the individual is born with XXY chromosomes. Essentially DSD take on many forms, some that have visible characteristics and some that don’t. While a few of these disorders are life threatening the majority of them are not. Especially when the only side effect of some is having ambiguous or a combination of genitalia that is not considered binary.
It wasn’t until the 1960s that doctors began recommending surgery for those who were intersex. Before, doctors had made their assumptions about the gender of the child and the parents would raise the child accordingly. It wasn't until the late 1990s that society began seeing being intersex as a defect and therefore began looking for a way to fix it (What Are). In 1996 the American Academy of Pediatrics said this in regards to intersex children “The Academy is deeply concerned about the emotional, cognitive, and body image development of intersexuals, and believes that successful early genital surgery minimizes these issues.” What these doctors consider successful surgeries as often has negative repercussions for the child. Firstly the determination of the person’s sex is greatly skewed by societal gender norms. (Maxwell) Often the determination of sex is based on the size of the phallus or clitoris. If the phallus was considered to be too small the child would be surgically altered and raised as a girl. If a child was born with a larger clitoris doctors would cut away perfectly healthy tissue for nothing but cosmetic reasons. These surgeries are conducted by following the Hopkins Model which encourages sexism as it implies that for young girls it is important for them to be fertile but it is not essential for them to feel sexual stimulus. Additionally it suggests that young boys should only be defined by the size and function of their genitalia. The Hopkins Model also encourages doctors to perform these surgeries as soon as possible (What’s Wrong).
There is a 40% chance that the gender the doctors assign will be rejected by the child (Tamar-Mattis). This is because what gender a person considers themselves falls on a spectrum that is influenced by personal experience, culture, and how each individual connects with their own identity. Essentially there is a big distinction between sex, a person’s physical characteristics and gender, a person’s self-identification. If later in life the child’s gender is different than the sex the doctors assigned them than the individual is faced with a very difficult road ahead. Genital reassignment surgery can cost upwards of $15,000 and depending on the surgeries inflicted upon the individual as a child, they might not be able to perform reassignment surgeries because of scar tissue (Tamar-Mattis).
In 1995 John Money, a psychologist, defended these surgeries by proposing that a child’s gender could be molded.

So surgeons could choose a gender and it was upon the parents to raise that child following strict gender roles so that the child would comply with the chosen gender. Therefore it was considered to be the parents fault if the child later rejected the gender (Maxwell). This added to not only the parents’, but the child’s shame of their bodies and completely disregarded any questioning of the surgeries malfunctionings. Children who are intersex are subjected to years of scrutiny and exposure to medical doctors and their language (Tamar-Mattis). Rarely is a child psychologist called in to assist the doctors and parents with their decision. This is because doctors often rush into the surgeries without fully explaining the child’s condition. There is no explanation given to the child, parents are not informed of any alternatives to surgeries, rarely are they informed of the success rates or any real benefits to the surgeries. Psychologically there is little support given to them or to the parents and many parents recall being pressured to allow “normalizing surgeries.” Those who are intersex may be less likely to seek help later in life because of the shame they felt as a child (What are). Many children are often not told of the repercussion that the surgery causes and they often don’t find out until later in life that they are infertile, or that they cannot experience sexual stimulation. This secrecy can cause distrust between the individual and the medical community. Often when patients would find out the surgeries they had been subjected to they would stop seeking medical attention, even if it meant not getting the hormones they needed. Many patients remark that they would feel very self conscious because their condition was considered so “freakish” that even doctors and professional would not be honest with them (What’s

Wrong).
Female Genital Mutilation, which is the partial to total removal of external genitalia is not legal in the United States and many other first world countries (What are). Society sees this as an act of torture, especially since it is done for non-life threatening reasons and can permanently harm the child. However, there is an exception to this law when it comes to intersex genital mutilation even though the surgeries cause similar side effects. For instance, some of the surgeries cut away at healthy tissue and create irreversible damage to the nerves rendering the a loss of sensation in the tissue (James). Other surgeries require the removal of the gonads, which results in infertility and the need for lifelong hormone therapy (Tamar-Mattis).
Most importantly, these surgeries are non consensual. Three former US Surgeons-Generals stated in 2017, “Theses Surgeries violate an individual’s right to personal autonomy over their own future” (Tamar-Mattis) Most of the doctors interviewed in a study done by the Humans’ Rights Watch said that the number of surgeries was going down, yet none said they had stopped performing these surgeries. There is very little data supporting the necessity of these surgeries, however there have been many studies which show the negative effects of these surgeries. There has been very little effort made by the medical community to stop or put regulations on these surgeries even though there has been decades of disagreement and rejection of these surgeries. Many doctors are starting to acknowledge that the surgeries are not always accurate or beneficial to the child’s help and other options should be available to the patients (Tamar-Mattis).
Most medical officials agree DSD is a psycho-social issue and yet DSD is primarily treated by surgeries (What’s Wrong). Intersex children would only need surgery if it was negatively affecting their health such as internal organs on the outside of the body or no opening for the urethra. If the child’s health is not endanger than there should be no issue with waiting until the child was of legal age to consent to any surgeries, if they wanted them. Parents additionally should not be able to consent in place of the child in non-essential surgeries, as it is not their body (The Rights). Some doctors believe that they only perform surgeries in extreme conditions or cases, however their definition of extreme is often skewed by societal standards (Tamar-Mattis).
In brief, those who are intersex should not be subjected to genital surgeries as infants because these surgeries are not always accurate about the child’s gender, can cause psychological damage later in life, they are not pertinent to the child’s well being and the child is unable to consent to the alterations. American society prides itself as a land of equality and freedom, however there are Americans who are being told that their conformity to societal norms is more important than their right to ownership over their own bodies and identities.

Works Cited
James, Susan Donaldson. “Intersex Babies: Boy or Girl and Who Decides?” ABC News, 17 Mar. 2011, abcnews.go.com/Health/intersex-children-pose-ethical-dilemma-doctors-parents-genital/story?id=13153068.
King, Barbara J. “What Does It Mean To Be Intersex?” National Public Radio, 19 Nov. 2015, www.npr.org/sections/13.7/2015/11/19/456458790/what-does-it-mean-to-be-intersex.
Maxwell, Malena. “Let's Talk About Intersex, Babies.” Grinnell College, WordPress, 22 May 2016, lewiscar.sites.grinnell.edu/HistoryofMedicine/uncategorized/lets-talk-about-intersex-babies/.
“The Rights of the Intersex Child.” National Organization of Circumcision Information Resource Centers, 1 Aug. 2016, www.nocirc.org/intersexed/.
Tamar-Mattis, Suegee, and Kyle Knight. “‘I Want to Be Like Nature Made Me’ - Medically Unnecessary Surgeries on Intersex Children in the US.” Human Rights Watch , 2017, www.hrw.org/report/2017/07/25/i-want-be-nature-made-me/medically-unnecessary-surgeries-intersex-children-us.
“What Are Intersex Rights?” Open Society Foundations, Oct. 2017, www.opensocietyfoundations.org/explainers/what-are-intersex-rights.
“What's Wrong with the Way Intersex Has Traditionally Been Treated?” Intersex Society of North America, 2008, www.isna.org/faq/concealment.