GENDER BASICS (cont'd):

*content are from Lynn Conway's website*

The practice of "surgically correcting" the genitals of intersex infants to make them "normal":

 

By the 1960's, advances in plastic surgery combined with the "Genitals + Upbringing" theory of gender identity led physicians to recommend "corrective" surgeries on many types of intersexed infants. The idea was to make the genitals look cosmetically correct for a boy or girl, and then raise the child in the corresponding gender, believing that the child would grow up to have a correspondingly normal gender identity.

 

John Money of Johns Hopkins University, who gradually became the medical community's dominant authority-figure in "gender-identity studies", was the leading advocate of such treatments. A believer in behaviorist psychology, in which the mind of the infant is thought to be a blank slate having no inherent personality characteristics, John Money theorized that gender identity was solely the product of upbringing and socialization.

 

The motive for doing "corrective" surgeries on infants was to solve the "social emergency" caused by an intersex birth. The very existence in nature of many intersex babies, with their many variations of genitalia, breaks down the strict male-female gender dichotomy of our culture. Thus the existence of intersex babies brings into question many deep religious and legal strictures. Parents and doctors are under incredible social pressure to eliminate these variations. John Money provided a theoretical rationale which validated intersex infant "corrective" surgeries, and made them appear to be "scientifically sound".

 

Since it was easier to surgically "make a girl" than to "make a boy", it frequently happened that XY intersex boys having small or missing penises were turned into girls. The fact that sensitive genital tissue was lost in the process didn't deter the surgeons, because for many years our society did not openly recognize that most women have strong sexual feelings and a capacity for orgasm. If the infant was turned into a girl, doctors didn't worry about whether she would later have strong erotic genital sexual feelings and enjoy lovemaking; they only worried about whether she would function sexually for her male partner's pleasure.

 

Surgeries on intersex infants have been done for many years now, with a frequency of about 1 in every 2000 births. In most cases the surgeries create girls. Amazingly, there was never any organized scientific follow-up to see how these cases turned out!

 

Even in the early years of these surgeries, there were people urging caution, most notably a young researcher named Milton Diamond, now a Professor at the University of Hawaii. While still a graduate student, Diamond made an audacious challenge to Money's theories in a 1959 paper entitled "A Critical Evaluation of the Ontogeny of Human Sexual Behavior". Diamond's insights were based on his own observations in animal experimentation. He further marshaled "evidence from biology, psychology, psychiatry, anthropology, and endocrinology to argue that gender identity is hardwired into the brain virtually from conception" (see As Nature Made Him, p.44).

 

However, the notions that human beings had "advanced beyond the influences of biological evolution in matters of sexuality", and that one's sexuality and gender were socially constructed, had already been deeply imprinted in the medical community. Under the influence of the "gender prophet" John Money, this view dominated medical and psychological thinking for the remaining decades of the 20th century. Infant intersex surgeries were performed by the thousands during those decades, and again without any follow-ups. Only as the century was closing did awful questions begin to arise, as occasional rare follow-ups revealed things hadn't turned out as Money predicted.

 

How these attempted "corrections" reveal that old theories of gender identify formation were wrong:

 

In recent years, many intersex people have "found each other" via the internet and begun to compare notes about their situations. As a result, it's become clear to intersex people themselves that many of the "corrective" surgeries didn't work out according to their doctors' theories. Instead, many intersex people were left genitally maimed by those infant genital surgeries. Many were also suffering from gender identity crises, because of having undergone arbitrary gender reassignments based on what it was "easiest for the surgeons to do".

 

Under pressure from intersex activists, especially the newly formed ISNA, follow-up studies have finally begun on infants who were "surgically corrected" over the years. The first such study, of 25 genetically XY boys who had missing penises as infants (cloacal exstrophy syndrome) and who had been surgically turned into girls and raised as girls, revealed that all 25 developed MALE gender identities.

 

Those kids, although raised as girls, had all exhibited the rough and tumble play of boys when young. By their teens, each of these kids insisted against all evidence of their female genitalia and upbringing that they were boys, and wanted to be changed into boys. Many of them desperately sought girlfriends, just as might any other teenage boys.

 

Instead of reversing their innate gender identities and turning these intersex boys into girls, the infant surgeries effectively turned them into the equivalent of female to male transsexuals! Many of these boys have since undertaken hormonal and social gender reassignment from female to male. Tragically, the effects of their infant genital surgeries preclude the surgical reconstruction of male genitalia and in many cases even preclude them from experiencing sexual pleasure and orgasm.

 

More lessons from intersex people about gender identity:

 

These recent studies call into question the entire existing practice of genital surgery on intersex infants.

 

The studies then do something even more awesome: They turn on its head the theory that genitals and upbringing determine gender identity, triggering a paradigm shift in the medical community's overall thinking about the underlying nature of gender identity. The personal experiences of intersex people who have traveled different gender trajectories (some "corrected" as infants, and some not) are now becoming more widely known about, and are helping build a deeper understanding of the many variations in gender identity that are independent of one's physicality.

 

For example, in intersex conditions such as XY-Turner mosaic (mixed gonadal dysgenesis) a child may appear to have normal male genitalia at birth and be raised as a boy, but then not masculinize at puberty and instead remain slight and feminine appearing. These teens can face great difficulties if their condition goes undiagnosed and/or if they do not become aware of good options for treatment. If they do not have a well-established male gender identity, they may face a difficult choice of whether to undertake testosterone treatments to masculinize and become men, or undertake estrogen treatments and genital surgeries to become women. In some cases, XY-Turner teens have female gender identities and if given a choice in the matter will chose reassignment as females.

 

The article "What do children know?", by Jane Spalding tells the compelling story of such a child who was raised as a boy, but who had a female gender identity and who sought hormonal and surgical reassignment as a female during her twenties. The existence of such cases further refutes John Money's proclamation that genitalia and upbringing establish gender identity:

 

Jane Spalding

 

Misguided by Money's theories for many decades, the medical profession has caused the irreversible physical maiming of thousands upon thousands of intersex babies. For compelling insights into the traumatic life experiences of an intersex person who was surgically "corrected" at birth, and who grew up without ever being told what had been done, see the recent interview of Cheryl Chase in Between the Lines: coming to terms with children born "intersexed", by Victoria Tilney McDonough.

 

Cheryl was the founding Director of the Intersex Society of North America (ISNA), and the early leader of the movement to end shame, secrecy and unwanted genital surgeries for people born with atypical reproductive anatomies. ISNA is working to end the idea that intersexuality is shameful or freakish. In the U.S. alone, five children are subjected to harmful, medically unnecessary sexual surgeries every day. ISNA urges physicians to use a model of care that is patient-centered, rather than concealment-centered. For more insight into these issues, see the Discovery Channel documentary "Is it a Boy or a Girl?", which was produced with ISNA participation.

 

Cheryl Chase, Founding Director of ISNA

"When an intersex baby is born, the default is usually to

perform surgery," says Cheryl Chase, who was surgically

"reassigned" female when she was 18 months old.

"Doctors want to 'fix' what is not right, then slap a diaper

on the baby, close the file, and send it off into it's life."