Gender Identity and Intersex Debate

In our generation today, there can be some common confusion on gender and sexual orientation. It was once believed that gender was determined by the genitals you were born with, however, in this day of age there is much more behind it. Although we are all born with either male or female gentiles there is also a social factor that plays into how we classify ourselves. In the book “Our Sexuality” by Robert L. Crooks and Karla Baur they define gender identity as: “each individual’s personal, subjective sense of their gender” (Crooks & Baur, 2018) (pg. 118). Many things can establish this for somebody, however the two that are the most important to consider are our genetics and also our social and cultural influences.

Social learning can start before we are even born. Our parents become pregnant and are rooting for either a boy or girl. When they find out the gender of their baby it is common to get excited for “gender specific” traits — sports and cars if they were to have a boy or princesses and ponies for a girl. Parents may paint a room pink or blue, or get specific toys depending on what gender their baby will be. Crooks and Baur compare and contrast a study that was done on parents about their newborns appearance and state: “Parents of boys described them as “strong”, “active,” and “robust,” whereas parents of girls used words such as “soft and “delicate”—even though all their babies were of similar size and muscle tone” (Crooks & Baur, 2018) (pg. 130).

These minor classifications continue on through the development and growth of a child. Our “social norms” tell us that men should be masculine while women should be feminine. When a boy falls during a sports event people tell him to “walk it off” whereas girls may be encouraged to feel empathy and give support. It is said in the textbook that: “By age 3, most children have developed a firm gender identity…. From this point, gender-identity reinforcement typically becomes somewhat self-perpetuating” (Crooks & Baur, 2018) (pg. 130).

Now that we have a better understanding of gender identity and how confusing it may be for some; let’s talk about intersex. In the textbook “Intersex” is defined as: “people who possess biological attributes of both male and female sexes” (Crooks & Baur, 2018) (pg. G-3). There are many disorders that people may be born with where there is some uncertainty on what sex they actually are. For example: in DHT- deficient males they are born with the chromosomes XY however their testicles do no descend until they are going through puberty. Because of this their genitals resemble a females for most of their life and then later when the testes do descend the person then more resembles a male. Another disorder called “cloacal exstrophy” is known to make a male baby be born with testicles, hormones, and the XY chromosomes, however, they are born without a penis. Due to these rare disorders that do occur, there has been a controversial spark being brought to intersex and healthcare professionals’ attention. If a baby were to be born without gender specific genitals, is it okay to surgically intervene?

When a baby is born intersex sometimes a surgery is performed to give the baby a specific sex. They determine which sex to surgically enforce by the functional ability, what parts they were or were not born with, and after a consultation with health care providers and the babies’ parents. After they determine what gender to make the baby, they perform surgery in order to make the genitals match whatever they decided was best. Although the baby was maybe born with the XY chromosome they may alter his genitals to a females, and parents are recommended to raise them as a girl. Johns Hopkins hospital made an actual protocol on surgeries of the intersex. Crooks and Baur note: “Long-term follow-ups of several intersex children treated under Johns Hopkins protocol revealed some of these individuals have had serious problems adjusting to the gender assigned to them” (Crooks & Baur, 2018) (pg. 132). This has brought up many ethical issues on consent and even further gender confusion later on in life for the child.

In 2015 the parents of a 10 year old boy sued doctors who surgically altered his genitals to a females after he was born with some major intersex complications. Their son had been adopted from foster care and had had the surgery prior to being adopted. Now that their son is growing up, he has expressed deep confusion on his assigned identity. His parents explain his surgery as “mutilation” and even state “There was no medical reason that this decision had to be made at this time” (Magaldi, 2015). They believe that the doctors who performed their sons’ surgery “violated his constitutional rights by having surgically removed his phallus… potentially sterilizing him and greatly reducing, if not eliminating, his sexual function” (Magaldi, 2015). Two years later their case won and the family was awarded $440,000 dollars for the surgery that had been performed but was not needed. The surgeons general report stated: “Cosmetic genitoplasty should be deferred until children are old enough to voice their own view about whether to undergo surgery… those whose oath or conscience says ‘do no harm’ should heed the simple fact that, to date, research does not support the practice of cosmetic infant genitoplasty” (Dieterle, 2017).

In contrast, when these surgeries were being done as Johns Hopkins Hospital the head of the team John Money believed that “a person is psychosexually neutral or undifferentiated at birth and that social-learning experiences are the essential determinants of gender identity and gender-role behavior” (Crooks & Baur, 2018) (pg. 132). This team believed that the decision should be made at a young age where the baby has no formed gender identity yet and would be able to live a normal life as their assigned gender. These surgeries are performed so that children will not be living in confusion of their gender or have “irregular” genitals.

In my personal opinion I do not agree with surgery to treat intersex patients so young. The reason I don’t agree with this is because I fully support having the patients consent before procedures that will alter their life drastically. Although there may be confusion being raised intersex and not having definite male or female genitals—I believe that there would be even further confusion if their genitals are surgically altered and that the patient should make the decision on surgery and gender preference when they can make an informed decision on their own.

References

1. Crooks, R. L., & Baur, K. (2018). Our Sexuality. Boston: CENGAGE Learning.
2. Dieterle, M. (2017, August 4). Parents of Intersex Child Win $440,000 Lawsuit Over Surgery. Retrieved from Law Street: https://lawstreetmedia.com/blogs/culture-blog/parents-intersex-child-win-440000-lawsuit-cosmetic-genital-surgery/
3. Magaldi, K. (2015, August 13). Parents Sue Doctors For Deciding Their Kid is a Girl. Retrieved from MSN Medical Daily: https://www.msn.com/en-us/health/pregnancyparenting/parents-sue-doctors-for-deciding-their-kid-is-a-girl/ar-BBlIUDA?ocid=iehp

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