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The Road to Hell is ...... paved with good intentions?The Good, the Bad and the Dangerous to Know -- a few choice quotes from our archives which provide an insight into the workings of the outer-galaxies of medicine, journalism and the patients themselves.
"My mother said she wanted to take me and run like hell, but the doctors implied that unless they made me look like other girls, I would be an outcast and commit suicide." "This [being born intersexed] really is the most awful thing that can happen to anybody," "Being intersexed isn't a negative thing. Not that we don't suffer, but like other minorities, we suffer because of prejudice." "Genital ambiguity in a newborn represents a true medical emergency. Early and expedient diagnosis is essential to avoid life-threatening crises, to determine sex-of-rearing, to provide for appropriate immediate and long-term treatment, and to assure that the family is provided adequate genetic counseling. Medical and surgical treatment should begin during the birth hospitalization and the child should leave the hospital with his or her external genitalia concordant with sex-of-rearing." "Male-dominated medical (particularly surgical) circles have "conspired" to mutilate apparently hermaphroditic individuals with PAIS and other conditions in the most brain-free fashion. We condemn female circumcision in Ethiopia and practise it freely in Western surgical circles in this and related conditions. " "I don't think that any kind of ridicule even comes close to being as harmful as the shame that results from what is not discussed." "Factors relating to success include: (1) prompt and appropriate sex assignment; (2) early and accurate diagnosis; (3) conservative reconstruction of the clitoris at an early age (less than 1 year); and (4) choice of vaginal reconstruction based on the severity of the malformation. Long-term follow-up demonstrates satisfactory anatomic and functional results when clitoral surgery alone was required. Functional results for patients with extensive vaginal reconstruction have been compromised." "Girls with masculinised genitalia will require genital surgery which is usually undertaken at about the age of one year. " The study of 59 children with a variety of intersex conditions notes that "Despite the sex assignment, genital organ correction soon after birth, psychological counseling of parents and intensive psychotherapy of children, general psychopathology developed in all groups ..." "Since the 1950s in America it has been standard to treat the birth of a child with unusual genitals as a "social emergency," and to remedy the discomfort of parents and doctors by genital surgery on the infant. Motivated in part by a fear that the children might grow up homosexual, doctors perform cosmetic genital surgery on about 1 in 2,000 children, the vast majority medically unnecessary. Outcomes are poor in functional, cosmetic and emotional terms. Surgeries are often repeated, sometimes over a dozen times. A profound shame prevents people from discussing what has happened to them. " "Hermaphroditism is a birth defect, not a separate sex. It's a silly pipe dream to imagine that, given children's irrepressible savagery toward anyone different, there will ever be a world in which young intersexuals will be happily accepted by their peers (outside of an Ivy League Montessori nursery school, where authoritarian caretakers craftily hover). Whether the chichi gender theorists like it or not, sexual duality is a law of nature among all highly evolved life forms. We are at a period in history when overpopulation allows us the luxury of not having to tie fertility to the survival of the human race." "Gender assignment involves consideration of future sexual functioning, fertility, and physical appearance. The information required to assign sex of rearing is usually available within 48 to 72 hours of birth. Management involves ongoing medical follow-up, timely surgical repair, and psychological counselling as needed. Parents require education with respect to sex differentiation and the specific disorder of their child. Normal psychosocial development is dependent on parents' confidence in their ability to raise their child according to the assigned sex." "The truth is, genital surgery is being done, but we don't know what the outcome of it is, sexually or otherwise. We don't have any long-term studies." "the need to make an early decision on gender for social purposes"
"I don't believe that the anyone at the Children's (hospital) ever spoke
to me or
asked me about genital sensation, orgasm, or masturbation, but it was a long
time ago, and I can't say for sure. No one explained anything to me before
or immediately after the surgery, but at age 10 or 11 they began to bring me
to the Children's (hospital) for "counselling" sessions, about an hour long
once per month. From age 15 to 17, the sessions were only about four times
per year. "Meanwhile, we have heard from some parents who say that their surgeon or endocrinologist actively discouraged them from contacting intersex advocacy groups". "As recently as April of 1996, the American Academy of Pediatrics (AAP) issued recommendations governing the Timing of Elective Surgery on the Genitalia of Male Children as follows: "Research on children with ambiguous genitalia has shown that sexual identity is a function of social learning through differential responses of multiple individuals in the environment. For example, children whose genetic sexes are not clearly reflected in external genitalia (i.e., hermaphroditism) can be raised successfully as members of either sex if the process begins before the age of 2 years. Therefore, a person's sexual body image is largely a function of socialization." The medical claim: "Now prepubertal in age, the girl has . . . a feminine gender identity and role distinctly different from that of her brother.. . . The final and conclusive evidence awaits the appearance of romantic interest and erotic imagery." The reality: "Joan's behavior during childhood failed to be "so normally that of an active little girl.....in a nutshell, the child never was and never became a normal girl. Now in his thirties, having married a woman with three children, John lives as a man". "In children with PAIS the decision on sex of rearing depends largely on the external genitalia. If these are sufficiently masculinised to permit sexual intercourse in the male role the baby can be brought up in the male sex but if not the baby is brought up in the female sex and will require external genital and sometimes vaginal surgery to a give normal female genital appearance and function. In PAIS there is a chance that the testes may eventually become cancerous; they should therefore be removed surgically as soon as convenient after the diagnosis is made" "The diagnosis AIS was verified by androgen receptor studies. At birth there was confusion as to the sex of the newborn. Originally, the subject was assigned to the male sex, but this decision was reversed 5 days after birth and the subject was reared as a girl. At age 30 the subject applied for gender reassignment treatment to the male sex. Upon psychological evaluation the gender identity was unambiguously male and the sexual orientation was exclusively towards women." "Agenesis of the penis is an extremely rare anomaly, occurring only once in 30 million births. This low incidence is responsible for the limited experience with this anomaly. There are only about 70 published cases, most reports being of one or two patients. This complex malformation requires urgent assessment at birth for several reasons: Female sex assignment is required early. Gonadectomy should be performed in the first few days of life to prevent male gender sex marking from the testosterone surge occurring between the tenth and the 60th day of life. Early gonadectomy and genital reconstruction helps the family to accept the child's altered gender and to reduce psychological problems".
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