Pediatric Ethics and the Surgical Assignment of Sex

Pediatric Ethics and the Surgical Assignment of Sex

One in every 2,000 babies born every year are neither male nor female, they are what is known as hermaphrodites. These children and their families are forced into a life of hardship and encounter many conflicts, which need to be addressed. Should the parents choose the assignment of the sex to a newborn child and subject them to a life of surgery and doctor visits? There are 100 to 200 pediatric surgical reassignments every year. Many of these children are subjected to doctor visits for the rest of their childhood. Worst of all, many of these children find themselves resembling or identifying with the gender opposite of that which their parents chose for them.

Conditions That Qualify for Gender Reassignment:

Over the past five decades, surgical interventions have been recommended as standard procedure for infants who are born with either ambiguous genitalia or who suffer from traumatic genital injury. Surgical advances in this century have made it possible for physicians to choose a gender for the child and then sculpt the appropriate genitalia. Some of the conditions that demand gender reassignment for children can be a result of chromosomal or hormonal defects.

Typically males have XY chromosomes, and women have XX chromosomes; however, hermaphrodites are neither male nor female. One reason comes from Turner's Disease where the chromosomes are XO, and there is a sex chromosome missing. Another mutation is the XXY chromosomes, known as Klinefelter's Disease, which occurs in an average of one out of every 1000 births. There is also, Mosaicism, where different cells split into different parts, making up XY and XO chromosomes. Hormonal complications can change the gender...

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... who believe the same. Surgery may never even be needed.

Conclusion:

To protect the lives of intersexed children, it is in their best interest if the parents wait until after the child reaches puberty before going through with the surgery.

Surgery should only be done if the child suffers from further health risks.

References

1) J. Money and A. Ehrhardt, Man and Woman, Boy and Girl

(Baltimore: John Hopkins University Press, 1972)

2) P.K. Donahoe, and J.J. Schnitzer, "Evaluation of the infant who has ambiguous genitalia, and principles of operative management,"

Seminars in Pediatric Surgery 5 (1996)

3) http://www.ukia.co.uk/diamond/ped_eth.htm

4) http://mind.phil.vt.edu/sex/emma.html

5) http://www.afn.org/~sfcommed/pedethics.htm

6) http://www.isna.org/library/recommendations.html

7) http://bmei.org/jbem/volume4/num2/scipione.htm