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A Light Still ShiningHere is a collection of quotes from the medical literature which demonstrate that there is a light still shining somewhere in the darkness of misinformation and confusion ... may those who are tempted to become the gender police for society take note and follow the light to where it leads.
"Rather than an occasion for emergency surgery and concealment, the birth of a baby with ambiguous genitalia may be an occasion for medical, parental and social humility and reflection, perhaps even for celebration". "Surgery and hormone therapy should only be consensual and informed. Kids know what sex they are if they are just left to work it out and feel loved and safe enough to talk to their parents about it. Intersexed children raised fairly neutrally could easily decide at puberty what sex they would be, or if they wanted to remain intersexed. Medical complications should be handled with love and honesty. Intersexed children are special so they should be made to feel that way... instead of like freaks or worse. Actually, it is really so simple." "Thus a fetus with two X chromosomes can develop testes and a penis of 'normal' dimensions and undergo entirely 'normal' male puberty (although he will be sterile, as are many 46,XY males). This condition is referred to as 'XX male'. Indeed these individuals are male and should not be regarded as anything but male. So the presence of two X chromosomes can not be regarded as a priori evidence for 'female-ness'."
"If in doubt do not assign gender . . . tell parents honestly that it is
uncertain. If gender has already been assigned by others, inform parents of
doubt...... "But what is an 'X'? And why should 2 Xes be a requirement for membership of the 'female' club? A chromosome is simply a collection of genes strung end-to-end and wound up in a long strand. The chromosome itself has essentially no function, it is simply the structure that is visible under a microscope. Furthermore, the genes carried on the chromosome can move from one chromosome to another by a process known as 'recombination'. " "Although I am a clinician and a scientist and have no expertise in psychology or psychobiology, I would contend that 'being' a man or a woman can NOT be simply ascribed to chromosomes or anatomy or hormones, but is the result of the complex interaction of all of these things in the context of family, peers and society as a whole". "In addition, private discussions with clinical ethicists indicate that some are beginning to take into consideration the points of view expressed by intersex advocates. One ethicist told us that his group had concluded that parents of newborn intersex children ought to be informed of the recommendations of intersex advocacy groups such as ISNA". "As a clinician I am faced with the task of trying to explain to parents or girls with AIS themselves, the nature of their condition in a way that does not erode their fundamental belief in their female-ness, but that nevertheless reveals the truth of their chromosomes and testes. I generally approach this by explaining that although MOST girls and women have 2 X chromosomes, there are some who do not. Although in the minority, they are not alone. So some girls have only one X chromosome, some have one-and-a-bit, and some have an X and a Y (actually, genetically speaking, the Y chromosome is just a degenerate X chromosome that has lost a number of its genes over the millenia. It began as an X in our biological forebears, but just lost bits of itself as time went by. The "Y" designation is just the natural flow-on from "X", but we could equally well call it "mini-X" or some such diminutive term). Similarly, although MOST girls and women have ovaries, there are some who do not. Girls/women with Turner syndrome have a fibrous 'streak' in place of an ovary; girls/women with AIS have a testis in place of an ovary (if it was not removed in infancy). These girls are not freaks or 'damaged males', they are simply part of nature's genetic variation". "Genital ambiguity is not an illness. The true sickness resides within a society which cannot tolerate difference. Some children may indeed be born with some genital ambiguity coupled with a congenital impairment of functioning affecting their health which does require medical help, but we are at risk of confusing "repair" with "reassignment". However, beyond purely medical issues, parents will benefit from supportive encouragement and advice regarding social/psychological/emotional factors, especially from the pre-existing support groups, run by intersexed people themselves, not well-meaning social agencies and medical staff, who may or may not be following their own agenda of "one size fits all". "There would need to be close monitoring of how much pressure may be placed on a child to agree to on-going treatment, which will serve to justify the early intervention, originally undertaken without the patient's consent. If any decision is taken with regard to gender-role by third-party "experts" and parents, to the exclusion of the young patient , then the pressures on that child to "fit-in" by demonstrating gender-appropriate behaviours is immense. Once the child "appears" (and I place this word in parentheses advisedly) to acquiesce to the stereotyped expectations of well-meaning (or self-interested) relatives, the process could take on a life of its own. The seemingly co-operative "I want to please mummy, daddy and the doctors" child is then fast-forwarded to a world of HRT and surgery - and in some cases, reversal HRT and surgery to undo the mistakes. This is not speculation here ... it happens .... even now". "The debate raises difficult questions about who has the right to decide what ranks as esthetically acceptable genitalia, whose interests are being served by surgical intervention and whether one's sexual identity is so entwined with the appearance of one's genitals that it is worth subjecting infants to a major operation to assure visual concordance between one and the other." "Should we have only two sexes?--my answer would be a resounding no. Most physicians have recommended in the past that the ambiguous external genitals of intersex infants be carved up so that the child will grow up appearing to be a "normal" male or female. Some infants have an enlarged or protruding clitoris; others will be born with a "micropenis". In about 90% of cases, intersex infants undergo genital surgery to make them appear as a "normal" female. One surgeon explained: "You can make a hole, but you can't build a pole." Surgery involves removal and remolding genital structures, and may involve the addition of parts taken from elsewhere on the body. Physicians now attempt to preserve structures that have concentrations of nerves, so that sexual feeling will remain. But they cannot guarantee that their patients will ever be able to have orgasms in later life. Such care was not always done in the past". "There is a group of doctors out there (and the number will grow) who have instead been taught that "it is more important to get gender assignment right in a process that involves the patient than to get it fast," that the patient should be fully informed and involved in decisions about surgery and hormones, that there is a wide range of genital anatomy ("not statistically normal does not mean pathological") and that there is a great need for early and consistent counseling in order to "get away from the veil of shame" so often associated with intersex issues. " "in ten years, not only will surgical options be better (for those who want them), but we'll be more open as people grow and change. Birth-gender can be different from adult gender, and that change is okay. We (the medical community especially, but really all of society) need to be more open and accepting of that gender fluidity in individuals." "In retrospect, it seems clear that the surgical refashioning of infants' genitalia must be assessed during the adulthoods of those patients, after the sexual organs take on their distinctive importance in intimate and procreative relationships. To judge success by genital appearance and psychosexual development prior to puberty is to fall victim to narrowed vision". "the standard of practice represents, not humility at all, but a striking appropriation by doctors of the authority to use the arts of medicine to police the boundary between male and female in the defense of cultural norms. Whether this hubris is intentional or not, the surgical concealment of intersexuality lends support to those who take for granted that there are but two sexual configurations, each associated with a distinct gender and sexual preference. In making available routine procedures for reconciling deviant anatomy to cultural expectations, medicine vastly empowers the implementation of "normality" even, we would add, as it diminishes the value of difference".
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