Sunday, September 24, 2006

Intersex Children

A fascinating article was just brought to my attention from the Trans-Academics group on Google. The article from today's health section of the NY Times (What if it's (sort of) a Boy and (sort of) a Girl?) has to do with whether or not intersexed children should be assigned a gender at birth. This may seem like something out of Jerry Springer to some folks, but the incidence of intersexuality is quite high somewhere between 1 in 2,000 and 1 in 4,500, so this is likely to be a condition a pediatrician will encounter at some point during his or her practice. The usual strategy has been to assign a gender and also surgically alter the genitalia to match. The article discusses the crusade of intersexed people to change this usual practice, focusing on Cheryl Chase of the Intersex Society of North America. Chase and other advocates for the intersexed, such as Alice Dreger, whom I have mentioned before, believe the best strategy is to rear the child in what seems to be the best gender for the child based on the medical evidence at birth-but not to rush into surgery.

The article reports:

She contends that the most important thing is for a child to feel loved by her parents, despite her difference. An operation, she says, should not be done to assuage parental embarrassment or anxiety; it should be chosen, if it is chosen at all, by an intersex individual who is old enough to make her own decision and give proper consent.


But getting families and Doctors to be open to letting the person make his or her own decision will be difficult even in today's social climate. The thought is that the problems the child might face growing up with ambiguous genitalia in some cases might be less than the need to correct an erroneous guess at the child's final gender identity.

Some of the medical guidelines are, well arbitrary. For instance babies with phallic structure (that's penises and clitorises) must be at least 2.5cm long on boys and shorter than 1.0 cm for girls. Since it is easier to make a vagina than reconstruct a penis those "phallic structures" in between are typically altered to be female in form.

The article notes that children seem to be able to determine what gender they are in one case studied by William Reiner, the article reports that a child assigned as female at birth, though she had been born male, leapt at the chance to identify as a boy saying:

Mom, I've been telling you: I'm a boy, and boys have short hair, so I cut off my hair.

Other links:

Creighton, Sarah. Surgery for Intersex J R Soc Med. 2001 May; 94(5): 218-220
http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=1281452

Another take on the NY Times article is at Jen Burke's Blog Transcending Gender:
http://www.jenburke.com/2006/09/24/cheryl-chase-in-the-new-york-times/

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