October 26/13 is the 17th Intersex Awareness Day

by Howie Fiedhior and Gina (of OII Australia) edited for 2013
also see:

Intersex people are people who have physical differences of sex anatomy other than brain sex alone. Their anatomical differences might include genetic, hormonal or genital differences or differences in our reproductive parts.

Happy Intersex Awareness Day to the small number of persons here in Jamaica, however here is a post I hope both intersex and non intersex persons will find informative as we do not forget to include the “I” in LGBTI agitation wordwide.

The first Intersex Awareness Day (IAD) came about when the American intersex group named Hermaphrodites with Attitude (HWA) teamed up with American Trans group Trans Menace to picket an American Association of Paediatrics (AAP) conference in Boston on 26th October 1996.

Those picketing this event were outraged that the doctors attending the conference were recommending and conducting infant genital surgery on intersex kids in order to make them more “normal”. Some of those protesting had been subjected to those kinds of surgery when they were infants.

The central message of Intersex Awareness Day (IAD) is the de-medicalisation of natural variations in a person’s sex anatomy. Intersex is not a disease, a disorder, a medical “condition”. The use of stigmatising language such as this has led to poor mental health, marginalisation even invisibilisation, and exclusion from social institutions for Intersex people.

On this day we hope to make as many people as possible aware of what intersex is and that intersex people everywhere lack those most fundamental human rights, the right to autonomy over our own bodies, the right to a life without discrimination, the right to a life without shame and secrecy.

In short it is a call for our right to an equal place in society.
Intersex is difference in the same way that eye colour or right- or left-handedness are differences or human biological variations. As with handedness or sexual orientation, societies have, in the past, looked upon human variations through the lens of prejudice and then sought ways to “cure” or eliminate that variation.

At a fundamental level homophobic bigotry, intolerance and ancient superstitions underpin contemporary mistreatment of intersex people.

Intersex people are subjected to forced gendering and surgical alterations to our bodies to “disappear” our differences in a society that regards difference in sex anatomy as deeply suspicious.

More on What is intersex?

Intersex refers to a series of medical conditions in which a child’s genetic sex (chromosomes) and phenotypic sex (genital appearance) do not match, or are somehow different from the “standard” male or female. About one in 2,000 babies are born visibly intersexed, while some others are detected later. The current medical protocol calls for the surgical “reconstruction” of these different but healthy bodies to make them “normal,” but this practice has become increasingly controversial as adults who went through the treatment report being physically, emotionally, and sexually harmed by such procedures.

Beside stopping cosmetic genital surgeries, what are intersex activists working toward?

Surgery is just part of a larger pattern of how intersex children are treated; it is also important to stop shame, secrecy and isolation that are socially and medically imposed on children born with intersex conditions under the theory that the child is better off it they didn’t hear anything about it. Therefore, it’s not enough to simply stop the surgery; we need to replace it with social and psychological support as well as open and honest communication.

What’s so significant about October 26?

On October 26, 1996, intersex activists from Intersex Society of North America (carrying the sign “Hermaphrodites With Attitude”) and our allies from Transexual Menace held the first public intersex demonstration in Boston, where American Academy of Pediatrics was holding its annual conference. The action generated a lot of press coverage, and made it difficult for the medical community to continue to neglect our growing movement. That said, events related to Intersex Awareness Day can take place throughout October and does not necessarily have to be on the 26th.

Important to Remember:
INTERSEX is not a part of transgender because intersex is not about gender. Intersex is about anatomical differences in sex.
Below are some of the differences in the experience of trans and intersex individuals
Trans:
Self-identified gender does not match apparent sex at birth.
Some human rights protection. In NSW this is limited to “recognised transgender” or people thought to be “transgendered” – 36B Anti-Discrimination Act 1977 in Australia.
Can change cardinal documents, but usually requires irreversible surgeries usually involving sterilization and applicants must not be married.
The right to marry someone of the opposite legal gender.
A full and functional reproductive system.
Physical differences limited to brain anatomy.
Transsexual people have an effective medical protocol that produces a 98% effective outcome with long-term studies and follow-ups.
The right to choose the time of surgery with extensive peer support.
The ability to participate fully and in an informed manner in their surgical and hormonal options.
Transsexual people generally have a strongly defined sense of gender – man or woman.
Can compete in sport up to and including Olympic level through established protocols.
Many effective and extensive organizations worldwide, with some NGOs attracting government funding (e.g. NSW Gender
Centre).
also see:

Offensive Terminology to Avoid when presenting Pro-Gay pointers ………

In light of recent letters to the newspapers and the seemingly over zealous race to bring certain issues to light several mistakes have been presenting themselves to be problematic in our defense and almost playing to the hands of the homophobes while crashing our very points we wish to present, one such letter in the Gleaner recently started off with the term “homosexual lifestyle”

Offensive: “homosexual” (n. or adj.)
Preferred: “gay” (adj.); “gay man” or “lesbian” (n.)

Please use “lesbian” or “gay man” to describe people attracted to members of the same sex. Because of the clinical history of the word “homosexual,” it has been adopted by anti-gay extremists to suggest that lesbians and gay men are somehow diseased or psychologically/emotionally disordered — notions discredited by both the American Psychological Association and the American Psychiatric Association in the 1970s. Please avoid using “homosexual” except in direct quotes. Please also avoid using “homosexual” as a style variation simply to avoid repeated use of the word “gay.” The Associated Press, New York Times andWashington Post restrict usage of the term “homosexual”

Offensive: “homosexual relations/relationship,” “homosexual couple,” “homosexual sex,” etc.
Preferred: “relationship” (or “sexual relationship”), “couple” (or, if necessary, “gay couple”), “sex,” etc.

Identifying a same-sex couple as “a homosexual couple,” characterizing their relationship as “a homosexual relationship,” or identifying their intimacy as “homosexual sex” is extremely offensive and should be avoided. These constructions are frequently used by anti-gay extremists to denigrate gay and lesbian people, couples and relationships.

As a rule, try to avoid labeling an activity, emotion or relationship “gay,” “lesbian” or “bisexual” unless you would call the same activity, emotion or relationship “straight” if engaged in by someone of another sexual orientation. In most cases, your readers, viewers or listeners will be able to discern people’s genders and/or sexual orientations through the names of the parties involved, your depictions of their relationships, and your use of pronouns.

Offensive: “sexual preference”
Preferred: “sexual orientation”

The term “sexual preference” is typically used to suggest that being lesbian, gay or bisexual is a choice and therefore can and should be “cured.” Sexual orientation is the accurate description of an individual’s enduring physical, romantic, emotional and/or spiritual attraction to members of the same and/or opposite sex and is inclusive of lesbians, gay men, bisexuals and heterosexual or straight men and women

Offensive: “gay lifestyle” or “homosexual lifestyle”
Preferred: “lesbian,” “gay,” “bisexual”

There is no single lesbian, gay or bisexual lifestyle. Lesbians, gay men and bisexuals are diverse in the ways they lead their lives. The phrase “gay lifestyle” is used to denigrate lesbians and gay men, suggesting that their sexual orientation is a choice and therefore can and should be “cured”

Offensive: “admitted homosexual” or “avowed homosexual”
Preferred: “openly lesbian,” “openly gay,” “openly bisexual”

Dated term used to describe those who are openly lesbian, gay or bisexual or who have recently come out of the closet. The words “admitted” or “avowed” suggest that being gay is somehow shameful or inherently secretive. Avoid the use of the word “homosexual” in any case

Offensive: “gay agenda” or “homosexual agenda”
Preferred: “lesbian and gay civil rights movement” or “lesbian and gay movement”

Lesbian, gay, bisexual and transgender (LGBT) people are as diverse in our political beliefs as other communities. Our commitment to equal rights is one we share with civil rights advocates who are not necessarily LGBT. “Lesbian and gay civil rights movement” accurately describes the historical efforts, by gay and straight people alike, to achieve understanding and equal treatment for LGBT people. Notions of a “homosexual agenda” are rhetorical inventions of anti-gay extremists seeking to create a climate of fear by portraying the pursuit of civil rights for LGBT people as sinister.

Another disturbing twist the putting into “past tense” transgender to pronounce or write it as “transgendered” one cannot be past something of which they are in other words one cannot now say they are something after being diagnosed as transgender. The Jamaica Observer for example makes that mistake in a recent article

Other terms to remember to use properly

Lesbian, Gay and Bisexual Glossary of Terms

Biphobia
Fear of bisexuals, often based on inaccurate stereotypes, including associations with infidelity, promiscuity and transmission of sexually transmitted diseases.

Bisexual
An individual who is physically, romantically, emotionally and/or spiritually attracted to men and women. Bisexuals need not have had equal sexual experience with both men and women; in fact, they need not have had any sexual experience at all to identify as bisexual.

Civil Union
Legal recognition of committed same-sex relationships in Connecticut, New Jersey & Vermont (see IN FOCUS: Civil Unions, Domestic Partnerships and Adoption).

Closeted
Describes a person who is not open about his or her sexual orientation.

Coming Out
A lifelong process of self-acceptance. People forge a lesbian, gay, bisexual or transgender identity first to themselves and then may reveal it to others. Publicly identifying one’s sexual orientation may or may not be part of coming out.

Domestic Partnership
Civil or legal recognition of a relationship between two people (domestic partners) that sometimes extends limited protections to them (see IN FOCUS: Civil Unions, Domestic Partnerships and Adoption).

Gay
The adjective used to describe people whose enduring physical, romantic, emotional and/or spiritual attractions are to people of the same sex (e.g., gay man, gay people). In contemporary contexts, lesbian (n.) is often a preferred term for women. Avoid identifying gay people as “homosexuals”

Heterosexual Man / Woman
A person whose enduring physical, romantic, emotional and/or spiritual attraction is to people of the opposite sex. Also straight.

Heterosexism
The attitude that heterosexuality is the only valid sexual orientation. Often takes the form of ignoring lesbians, gay men and bisexuals. For example: a feature on numerous Valentine’s Day couples that omit same-sex couples.

Homosexual
Outdated clinical term considered derogatory and offensive by many gay people. Gay and/or lesbian accurately describe people who are attracted to members of the same sex.

Homophobia
Fear of lesbians and gay men. Prejudice is usually a more accurate description of hatred or antipathy toward LGBT people.

Lesbian
A woman whose enduring physical, romantic, emotional and/or spiritual attraction is to other women. Avoid identifying lesbians as “homosexuals,” a derogatory term.

LGBT / GLBT
Acronyms for “lesbian, gay, bisexual and transgender.” LGBT and/or GLBT are often used because they are more inclusive of the diversity of the community.

Lifestyle
Inaccurate term often used by anti-gay extremists to denigrate lesbian, gay, bisexual and transgender lives. Avoid using. As there is no one heterosexual or straight lifestyle, there is no one lesbian, gay, bisexual or transgender lifestyle.

Openly Gay
Describes people who self-identify as lesbian or gay in their public and/or professional lives. Also openly lesbian, openly bisexual, openly transgender.

Outing
The act of publicly declaring (sometimes based on rumor and/or speculation) or revealing another person’s sexual orientation without his or her consent. Considered inappropriate by a large portion of the LGBT community.

Queer
Traditionally a pejorative term, queer has been appropriated by some LGBT people to describe themselves. Some value the term for its defiance and because it can be inclusive of the entire LGBT community. Nevertheless, it is not universally accepted even within the LGBT community and should be avoided unless quoting someone who self-identifies that way.

Sexual Orientation
The scientifically accurate term for an individual’s enduring physical, romantic, emotional and/or spiritual attraction to members of the same and/or opposite sex, including lesbian, gay, bisexual and heterosexual orientations. Avoid the offensive term “sexual preference,” which is used to suggest that being gay or lesbian is a choice and therefore “curable.”

Sodomy Laws
Historically used to selectively persecute gay men, lesbians and bisexuals, the state laws often referred to as “sodomy laws” were ruled unconstitutional by the U.S. Supreme Court inLawrence v. Texas (2003). “Sodomy” should never be used to describe gay, lesbian or bisexual relationships, sex or sexuality.

TRANSGENDER TERMINOLOGY TO AVOID

PROBLEMATIC TERMINOLOGY

PROBLEMATIC: “transgenders,” “a transgender”
PREFERRED: “transgender people,” “a transgender person”
Transgender should be used as an adjective, not as a noun. Do not say, “Tony is a transgender,” or “The parade included many transgenders.” Instead say, “Tony is a transgender person,” or “The parade included many transgender people.”

PROBLEMATIC: “transgendered”
PREFERRED: “transgender”
The word transgender never needs the extraneous “ed” at the end of the word. In fact, such a construction is grammatically incorrect. Only verbs can be transformed into participles by adding “-ed” to the end of the word, and transgender is an adjective, not a verb.

PROBLEMATIC: “sex change,” “pre-operative,” “post-operative”
PREFERRED: “transition”
Referring to a sex change operation, or using terms such as pre- or post-operative, inaccurately suggests that one must have surgery in order to truly change one’s sex.

PROBLEMATIC: “hermaphrodite”
PREFERRED: “intersex person”
The word “hermaphrodite” is an outdated, stigmatizing and misleading word, usually used to sensationalize intersex people.

DEFAMATORY TERMINOLOGY

Defamatory: “deceptive,” “fooling,” “pretending,” “posing,” or “masquerading”
Gender identity is an integral part of a person’s identity. Please do not characterize transgender people as “deceptive,” as “fooling” other people, or as “pretending” to be, “posing” or “masquerading” as a man or a woman. Such descriptions are extremely insulting.

Defamatory: “she-male,” “he-she,” “it,” “trannie,” “tranny,” “gender-bender”
These words only serve to dehumanize transgender people and should not be use

Transvestite
DEROGATORY see Cross-Dressing in US standards but locally the term has been used to separate a transgender person from a drag queen in our advancing culture in the mainstream.

TRANSGENDER-SPECIFIC TERMINOLOGY

Transgender
An umbrella term for people whose gender identity and/or gender expression differs from the sex they were assigned at birth. The term may include but is not limited to: transsexuals, cross-dressers, and other gender-variant people. Transgender people may identify as female-to-male (FTM) or male-to-female (MTF). Use the descriptive term (transgendertranssexualcross-dresser, FTM or MTF) preferred by the individual. Transgender people may or may not choose to alter their bodies hormonally and/or surgically.

Transsexual (also Transexual)
An older term which originated in the medical and psychological communities. Many transgender people prefer the term “transgender” to “transsexual.” Some transsexual people still prefer to use the term to describe themselves. However, unlike transgendertranssexual is not an umbrella term, and many transgender people do not identify as transsexual. It is best to ask which term an individual prefers.

Transition
Altering one’s birth sex is not a one-step procedure; it is a complex process that occurs over a long period of time. Transition includes some or all of the following cultural, legal and medical adjustments: telling one’s family, friends, and/or co-workers; changing one’s name and/or sex on legal documents; hormone therapy; and possibly (though not always) some form of surgical alteration.

Sex Reassignment Surgery (SRS)
Refers to surgical alteration, and is only one small part of transition (see Transition above). Preferred term to “sex change operation.” Not all transgender people choose to or can afford to have SRS. Journalists should avoid overemphasizing the importance of SRS to the transition process.

Cross-Dressing
To occasionally wear clothes traditionally associated with people of the other sex. Cross-dressers are usually comfortable with the sex they were assigned at birth and do not wish to change it. “Cross-dresser” should NOT be used to describe someone who has transitioned to live full-time as the other sex, or who intends to do so in the future.Cross-dressing is a form of gender expression and is not necessarily tied to erotic activity. Cross-dressing is not indicative of sexual orientation.

Gender Identity Disorder (GID)
A controversial DSM-IV diagnosis given to transgender and other gender-variant people. Because it labels people as “disordered,” Gender Identity Disorder is often considered offensive. The diagnosis is frequently given to children who don’t conform to expected gender norms in terms of dress, play or behavior. Such children are often subjected to intense psychotherapy, behavior modification and/or institutionalization. Replaces the outdated term “gender dysphoria.”

Intersex
Describing a person whose biological sex is ambiguous. There are many genetic, hormonal or anatomical variations which make a person’s sex ambiguous (i.e., Klinefelter Syndrome, Adrenal Hyperplasia). Parents and medical professionals usually assign intersex infants a sex and perform surgical operations to conform the infant’s body to that assignment. This practice has become increasingly controversial as intersex adults are speaking out against the practice, accusing doctors of genital mutilation.

GENERAL TERMINOLOGY

Sex
The classification of people as male or female. At birth, infants are assigned a sex based on a combination of bodily characteristics including: chromosomes, hormones, internal reproductive organs, and genitals.

Gender Identity
One’s internal, personal sense of being a man or a woman (or a boy or girl.) For transgender people, their birth-assigned sex and their own internal sense of gender identity do not match.

Gender Expression
External manifestation of one’s gender identity, usually expressed through “masculine,” “feminine” or gender variant behavior, clothing, haircut, voice or body characteristics. Typically, transgender people seek to make their gender expression match their gender identity, rather than their birth-assigned sex.

Sexual Orientation
Describes an individual’s enduring physical, romantic, emotional and/or spiritual attraction to another person. Gender identity and sexual orientation are not the same. Transgender people may be heterosexual, lesbian, gay, or bisexual. For example, a man who becomes a woman and is attracted to other women would be identified as a lesbian.

Radio program “Love & Sex” on Sexual Identities & Transgenderism (Were you born in the wrong body?)

December 1st, World AIDS Day the Jamaican transgender community got a chance to voice their concerns through representative “Jane” on a radio program aired on Newstalk 93FM

named :Love and Sex” hosted by Jamaican Clinical Sexologist of The Caribbean Sexuality Research Group (CSRG) Dr. Karen Carpenter and co-host Gavin Walters. Sexual identities were the broader subject of the discussion as other variants and orientations were also examined. It is not very often the local transgender community gets an opportunity on the airwaves to share real information on their lives and to dispel the misconceptions about their community and the mix up with the Lesbian, Bisexual and Gay lifestyles.
Host Dr. Karen Carpenter made mention of Cuba’s lead in public education on sexual identities and their interventions with the various groups. She highlighted the outreach there as providing jobs and overlooking the packaging of persons but more so seeing people as people.
Dr. Marilyn Volker famed international Sex Therapist who has worked with transsexuals in the United Stated as well was also a guest on the one hour and forty two minute discussion touched on the possible causes of transgenderism to sexual orientations and identities.
(photo from GIRES) Gender Identity Research and Education Society UK

The opening dialogue before the interview also dealt with the differences between Transgender, Transvestite and or Cross dressers. Being the qualified person that Dr. Carpenter is she simply defined the differences.

  • Transgender – seems themselves as a different gender than the one they were born as physically also known as body dysmorphia or born in the wrong body. The person is unable to conceptualize themselves as the sex they are physical in. Sexual re-assignment surgery is used to make the changes for the individual.
  • Transvestite – Persons who like to dress in clothing of the opposite sex mostly for entertainment.
  • Inter sexual – persons born with undefined genitalia or sexual organs.
  • Drag Queens – Dr. Carpenter referred to famed diva Rupaul or males who wear female clothing either for entertainment or just comfort.

Dr. Marilyn Volker Adjunct Professor with the University of Miami Florida, Florida International University and Diplomat of the American Board of Sexology, Associate Fellow of the American Academy of Clinical Sexologists and teacher to Dr. Karen Carpenter was introduced. She also hosted a program Sex with Marilyn. She contributed much to the discussion.
She contributed among other things:

Sexual Identity: consists of four parts, Biology consisting of chromosomes and hormones persons need to look at the brain structure and not the sexual organs to determine the finality. Gender identity is the second part; it’s the brain that determines sexual identity not the genitals. i.e. male, female or in between no matter what sexual organ the person has. The there is gender role that means how persons appear or dress, if we went by what the sexual organs are and not what exist between the ears we may be dressing a child or person of a different gender. We must see children and people with the heart and not by outward appearance. Gender role is on the external, Gender identity is on the internal Sexual orientation is the last no matter what is between the legs of the person, or the brain orientation is who one is attracted to.
So a transgendered person could be right handed or ambidextrous, heterosexual, homosexual or bisexual. It is very complicated at times but bear in mind what’s between the legs and ears doesn’t necessarily match how a person dresses.
Dr. Volker referred to twin studies where pairs of twins have different orientations that suggest there is more than just parenting, social and chromosomal and hormonal structure of each person. A child in as far as identity is concerned that may be born with a vagina may get more male hormones when in the uterus it could develop a masculine brain with feminine private parts.
The term for matches in sync with brain identity versus physical genitalia is CISGENDER transgender is the opposite and doesn’t match. In one in every two to five thousand births there is some difference in chromosomes and hormones. There maybe ambiguous development during birth. When there is a combination of chromosomal hormones in the middle that leads to ambiguous genitalia it is called inter sexuality also called androgyny (outside of entertainment use for rock music). Androgyny comes from the Greek word “Andro” Male and “Gyny” Female suggesting behaviour roles as well identifying with a wide range of activities and feelings excluding biological concepts.
“Jane” the leading local transgendered voice was introduced to the program where she explained she discovered she was trans when she was six years old but never started the process of living as trans female until her late twenties. She explained she was born male growing up she acted effeminate and liked doing girl’s things. “Living in Jamaica one knows that kind of thing is not normal” so she hid it depicting a male persona even becoming a bully at school using it as a shield. She adopted a very macho personality using it as a shield and became in Jamaican terms “a girl’s man” i.e having many girls and hyper masculine or the stereotypical yard man. In doing so she tried to purge the feelings within and the guilt of growing in a Christian home with heathen thoughts. She adopted a destructive cycle while cross dressing in private with suicidal thoughts which temporarily relived the tension. She would often destroy and burn feminine personal possessions only to recycle the same actions all over again. She struggled with the fact that she was still a man; the early morning boner was like “alien appendage” to her. She also had a fiancée while as a man but eventually broke off the engagement; persons were shocked upon discovering her “change” as family shunned her save and except for her father surprisingly as mothers are expected to cope with this better, she has since become accommodating.
Dr. Volker responded by emphasizing doctors are now realising through brain scans, hormonal tests and chromosomal tests to say to parents with children who are possibly transgendered that one may have a child who has a particular genitalia but is the opposite sex in the brain. If many parents and troubled transgendered persons were told as early as birth what the proper diagnosis is then a lot of the problems similar to the ones described by Jane would have been avoided. She also touched on chromosomal issues as in X and Y versus hormonal levels in determination of the baby’s sex, usually in a female it’s XX and a male XY, there are children born XXY born with a penis but an extra female chromosome meaning they could look more feminine or look masculine on the outside with a penis with a feminised brain, things can occur during birth. Usually girls get XX patterns with more estrogen and progesterone while most boys gets XY patterns with testosterone and androgen sometimes there is a mix in the uterus where a mix of chromosomes like XXY leading to less masculine development somewhere. There may even be more testicular tissue in girls where this mix up occurs. The available tests now can see into the hormonal and chromosomal structures. The pediatrician can now ask a parent does the they like to or want to know the chromosomal structure of their child.
Jane continued that she harnessed the power of the Internet as there were few doctors in Jamaica who knew about transgenderism. She sourced her own hormones from the Internet, she looked at the Harry Benjamin principles of care and read where possible medical journals. Dr. Volker noted that several Trans persons have to teach their doctors about the issues. Jane noted her website was down at this time. She is aware of ten individuals in Jamaica living as women some of whom are lost in the gay community due to the lack of education for them. Dr. Volker said the important thing is what the brain is attracted to and not the physical. There maybe a heterosexual female born in a girl who has a penis her brain maybe attracted to a male who maybe mistaken as gay. There maybe need for a serious re-socialization process globally to deal with these new phenomenons. One would have to also go to gender specialists, endocrinologist to get more professional and detailed information.
Jane highlighted she is pre-operative transgender meaning she has not done the full sexual re-assignment procedure so she can father a child now but after surgery cannot have children naturally or get pregnant. She plans to have the surgery as soon as she can find the money.
In answering Dr. Volker’s questions on her orientation Jane responded bisexual. Dr. Volker continued to explain that gender identity and orientation differ in the trans world. She has worked with transgendered who have moved from having a penis while trying to be heterosexual male but their brain was heterosexual female but couldn’t express it as they would look as if they were gay on the outside,” it is confusing to persons going through the issues.” She emphasized the need for support. Jane continued on the lack of support systems in Jamaica except the Internet or possibly contacting JFLAG who may put one on to other transgendered persons.
Dr. Carpenter noted that the Caribbean Sexuality Research Group (CSRG) offers some support to transgender persons and runs a free clinic at the UHWI Psychiatry Unit which has been running for the last month by calling 977-0316 with a small registration fee of $500.00, leave a message for appointments as all calls are answered.
She also remarked on the misconception of homosexuality and paedophilia and the tabloid papers sensationalism creating the homo-negative perceptions over time. “The minute we find out someone’s sexual orientation is different from others we begin to monitor, oh they must be about to hit on somebody which is inappropriate.”
She highlighted that paedophilia happens when there is an economy is depressed and the power differential between the adult versus the young person despite sexual orientation is wide.On the matter of gender variant children from a caller to the program Dr. Volker suggested that the child be monitored by a pediatric endocrinologist or a child psychiatrist who understands gender. Children who present with the mis-match usually the assessment is done in early puberty where hormones may be administered dependent on the case to stop the actions opposite to the physical presentation but the sexual re-assignment surgery is left to later in life in most cases unless they were born with both genitals or intersex. (A practice which is opposed by some intersex activists)Program continues to the end.

Peace and tolerance.

H

Tell Me Pastor on oral sex: “Therefore, as a counsellor, I do not advocate oral sex, but neither do I condemn those who practice it.”

The Star’s “Tell Me Pastor” says as a psychologist he doesn’t condone or condemn oral sex basically so long as it is practiced in a heterosexual setting and the couple of course is married and leading towards procreation or having children. So much for gay and lesbian people who like the act. I think pastor seems to forget the realities of Jamaica “Land We Love” that sex is not only done by married folks and oral sex though more tolerated now is still taboo for some especially an ever shrinking but still defiant section of dancehall.

Isn’t it funny that though homosexuality has been removed from the DSM IV document so long ago in the American Psychiatric Association (APA)principles that in effect guides or is used as a standard bible by psychiatrists and psychologists worldwide in their pratice he finds homosexuality wrong and condemns it readily. Maybe that is done to remain popular on radio as he hosts a talkshow besides his paper column.

Of interest just take a look at the quality pf the letters written to him in the very edition the letter excerpted below appeared. I have always contended that they are written for the column as there are other letters in the edition speaking to the matter of oral sex.

Hypocrisy at best here folks but you can decide for yourselves.

GO HERE

Also see: Tell Me Pastor’s Blog http://tellmepastor.blogspot.com/

Also see: Tell Me Pastor shows clear ignorance and lesbophobia

See the letter below, the indented font is the letter by the writer and the bold font is the pastor’s response. Judge for yourselves.

The Oral Word:

Dear Pastor,

Can you please tell me where in the Bible oral sex is wrong and forbidden? I enjoy having oral sex and my wife enjoys it more than penetration. When we have oral sex her water comes several times. But when we have sex the regular way, she hardly comes and she says she is not satisfied.

Some say the mouth was not made to be used that way, so it is wrong to have oral sex. But we don’t see anything wrong with it.

F., Portland

Dear F.,

The Bible does not say anything about oral sex. Christian couples are under obligation to please each other and should do anything as expressions of love.

The Bible teaches that sex within the marriage bond is not only for procreation but also for pleasure. Therefore one should not judge or condemn what a couple does in their bedroom.

A man should sexually satisfy his wife, and his wife should do the same. Therefore, as a counsellor, I do not advocate oral sex, but neither do I condemn those who practice it.

Please read first Corinthians 7: 3-5.

Pastor

The term: Genderqueer

Genderqueer

The term “genderqueer” began to be commonly used at the turn of the twenty-first century by youth who feel that their gender identities and/or gender expressions do not correspond to the gender assigned to them at birth, but who do not want to transition to the “opposite” gender. Characterizing themselves as neither female nor male, as both, or as somewhere in between, genderqueers challenge binary constructions of gender and traditional images of transgender people.

Genderqueers use a wide variety of terms to describe themselves, including transboi, boydyke, third gendered, bi-gendered, multi-gendered, androgyne, and gender bender. Sometimes they refuse to attach a label to their gender identities at all, feeling that no one word or phrase can adequately capture the complexities of how they experience gender.

Since Christine Jorgensen made international headlines in the early 1950s for having a “sex change,” the dominant model of transgender identity development has involved individuals who recognize themselves at a young age as a gender different from their birth gender, struggle to understand these feelings, and after years of shame and denial, begin to accept themselves. Typically in mid-life they take hormones and have gender confirmation surgeries to align their outward appearance with their inner sense of self.

But in the last decade, there has been a fundamental shift in how many transgender people conceive and express their gender identities, as demonstrated by the increasing number of young trans people identifying as genderqueer.

Trans youth today, who have access to information on the Internet, see a growing number of transgender images in popular culture, and benefit from the political and social gains made by previous generations of transgender activists, are much less likely than transgender people who grew up in the 1960s to mid 1990s to feel that they are the “only one.” As a result, trans youth in the 2000s may acknowledge and embrace their transgender identities more quickly and may depend on each other, rather than the medical profession, for support and validation.

Many trans youth also do not believe that they need to transition entirely or at all in order to be “real” men or “real” women. Refuting the idea that one’s genitalia is the defining aspect of one’s gender, they may take hormones, but not have any surgeries, or they may have a breast augmentation or reduction procedure, but not genital surgeries, or they may reject medical intervention altogether.

Some trans youth may seek to blur gender boundaries, such as by having an androgynous appearance or by wearing both “male” and “female” clothing. Thus, while genderqueers commonly refuse to conform to traditional (trans)gender expectations, there is no one way to enact or express a genderqueer identity.

For much of the 1990s, the term “transgender” was often shorthand for “transsexual,” but the “transgender” umbrella is increasingly recognized as including a myriad of genderqueer, and other gender-diverse, identities. And as more and more people identify as genderqueer, the less society will be able to foster and enforce a male/female gender dichotomy.

Brett Genny Beemyn

A religious perspective on the Caster Semenya issue

Interesting analogies to the Semenya saga as appearing in today’s Gleaner, read and tell me what you think, lgbtevent@gmail.com

Caster Semenya: Why, God, why?
Sean Major-Campbell

The reality of God’s child, Caster Semenya, presents us with many questions. Why should God allow an unpopular, uncommon human being to be born in a world that discriminates against those who are ‘different’?

It seems so unfair. It may even seem unjust. Oppressive even! Why, God?

Why, when she will be condemned, scorned, even despised by some of the most religious followers of God?

Peta-Ann Baker was excellent in her piece ‘What if Semenya were Jamaican?’ (The Sunday Gleaner, September 6). This should be required reading or required hearing for all who would seek to understand more about the subject of human sexuality.

Since she is a celebrity, God’s Semenya brings into focus the issue of being ‘sexually different’. In Semenya’s experience, the state of being a synchronous hermaphrodite (presence of both male and female gonads) is not even the case. In the absence of a gender-specific identity, could Semenya be ever described as heterosexual or homosexual? What implications might all this have for our transgendered sisters and brothers?

divine leaning

There is one school of thought which interprets the Yahwist creation account as a divine leaning towards creating a hermaphrodite. It is not being suggested here that that was God’s intention. Just noting that the androgynous – the human – Adam was simply created. Later, God seems to have decided to include another sex in the person of Eve.

Then there is the whole matter of Jesus’ affirmation of eunuchs. Who were eunuchs in the ancient world? This should make interesting exploration. Jesus, in Matthew 19:11-12, gives a word which is not often recalled in our cultural context.

When his disciples suggest that it may be better not to marry (in light of the discourse on divorce), Jesus responds by acknowledging three groups of persons. He, however, prefaces his thesis by acknowledging that “Not everyone can accept this word …”

The three groups of persons are:

Eunuchs by birth

Eunuchs made by people (castrated)

Eunuchs by choice (renouncing marriage)

Imagine Jesus saying this to a group of Jamaican macho men! From the perspective of psychological biblical criticism, it is understandable why we would have a preference for quoting, “Therefore shall a man leave his father and mother ….” But how often do we hear reference to Matthew 19:11-12?

Maybe this topical issue is a reminder of how God is not gender specific in terms of divine identity. Our response to God’s Semenya may determine whether we lock ourselves into gender stereotypical dogma.

The gendering of God has for centuries assured negative patriarchal values, condemned women to being the lesser or weaker sex, and ensured the preservation of various unethical constructs.

God’s Semenya reminds us that life is not always about black or white, right or wrong, high or low! The answers to life’s questions are just not always as simple as pulling a Bible verse. Reality is not polarised for ease of comprehension.

Does it offend to hear that God is not gendered? Why would God need sexuality? Yes, it is true that pagan gods were male, female, or both, since this affirmed their reproductive ‘capacity’.

The Omnipresent, Omniscient, Omnipotent, Ultimate does not need the limitation of gender identity. This is only required where continuation of the species depend on sexual activity.

Should there be a debate?

Is Semenya a human being? Should there be a debate with regard to Semenya’s entitlement to human rights consideration? What if ‘other Semenyas’ wanted to be married to each other? What if Semenya was your child?

How do Christians – those with all the answers – respond to these questions? Is this an unfortunate situation? If ‘yes’, is God unfair? If ‘no’, would you marry someone like God’s Semenya?

It is my hope that we will find compassion for Semenya. Let us use this reality to move beyond dinner table and bar counter jokes, to a more reasoned dialogue with ourselves. Let us engage that strange and often challenging place between faith and other life experiences.

Fr Sean Major-Campbell is former rector of the Anglican Church in the Cayman Islands. The views expressed do not necessarily represent those of the Diocese of Jamaica and the Cayman Islands. He may be contacted at seanmajorcampbell@yahoo.com

Intersexuality, Ambiguous Genetalia & Psycho-social issues Discussion on Nationwide Radio Jamaica 11.09.09

Comment | Copy This

Comment | Copy This

Host Cliff Hughes follows up on reports that an Australian newspaper says Semenya Caster is a hermaphrodite. Dr. Karen Carpenter (Psychologist & Clinical Sexologist) and Dr. Rosemary Wright Pascoe (Consultant Endocrinologist)are interviewed. They go into great detail describing the possible conditions that come under hermaphroditism and intersexuality.

part 2 of the discussion on Nationwide with Semenya Caster’s reported test findings suggesting she is a hermaphrodite goes more into Ambiguous genetalia and the other psychological issues and puberty are examined in detail by the Clinical sexologist and Psychologist.

Not very often do we hear Jamaican radio carry progressive discussions of this nature without some satirical or synical touch to it.

Feedback
www.snapvine.com/glbtqja
lgbtevent@gmail.com

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Caster Semenya, Suicide watch…what?

According to an article appearing in a publication named medindia, Miss Semenya is allegedly being watched carefully by her close associates to track her mental stability.

Sad that the results of her examination is alleged to have been leaked to sections of the media, these leaked details of the probe by the ­International Association of ­Athletics Federations showed the 800m starlet had male and female sex organs – but no womb and that she was a hermaphrodite. Lawmaker Butana Komphela, chair of South Africa’s sports committee, was quoted as saying: “She is like a raped person. She is afraid of herself and does not want anyone near her. If she commits suicide, it will be on all our heads.

The best we can do is protect her and look out for her during this trying time.” South African athletics officials confirmed Semenya is now receiving trauma counselling at the University of Pretoria. Caster has not competed since the World Athletics Championships last month when the IAAF ordered gender tests on her amid claims she might be male.Source-ANI

Apart from her South African countrymen where is the support from the rest of the world, is everyone watching to use her as a guinea pig so next we can reference her as a case study. I am appalled by this, I would have thought that some groups would have banded together to aid in her defense whilst opening the eyes of the public to inter sexuality.

Well let us pray for her and hope that this cup passes and she can move on.

Thanks to Pam Spaulding for alerting us to this.

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What makes ‘HER’ female?

Heather Little-White, Ph.D.

The controversy over Caster Semenya, who won the 800-metre race in the recent World Championships in Athletics, in Berlin, Germany, and the request by the authorities for a gender verification, brings into sharp focus the elements of the human sexes.

One common stereotyped assessment of male versus female by the common man is penis equals male and no penis equals females. Later, add breasts to better define females at first glance compared to men. Facial features and voice further help to identify the sexes.

Unique system

Each sex has a unique reproductive system which influences their sexuality and reproductive capabilities designed to transport the egg or the sperm. The female reproductive system is located entirely in the pelvis. If one were to examine the female, there are distinctive elements to differentiate male from female. The external part is known as the vulva, meaning ‘covering’ for the vagina and other reproductive organs inside the pelvic area.

The mons pubis is the fleshy area just above the top of the vaginal opening.

The labia are the two flaps of skin (lips) surrounding the opening to the vagina.

The clitoris is a small organ with a bundle of nerves located toward the front of the vulva where the folds of the labia join.

Between the two lips (labia) are openings to the urethra and the vagina. Contrary to what many people think, including females who do not know their own bodies, the urethra is the canal that transports urine from the bladder to the outside of the body. Urine does not come through the vagina.

Hollow tube

The internal reproductive organs of the female include the vagina, uterus, fallopian tubes and ovaries. The vagina is a hollow tube made up of muscles and extends from the opening to the uterus, running three to five inches long. The muscles in the vagina allow the vagina to expand and contract during intercourse and childbirth. The walls of the vagina are lined with mucous membrane to keep it moist and protected.

A thin sheet of tissue called the hymen, with one or two holes, partially covers the opening of the vagina. The hymen is different from one female to another. Most females may stretch or tear the hymen during their first sexual experience and the hymen may bleed slightly. However, some women who have had sex do not experience much change in their hymens.

Contractions

The vagina connects to the uterus or the womb at the neck of the womb or cervix which has thick, strong walls. The uterus which is only about three inches long and two inches wide, has thick lining and strong muscular walls that expand and contract to accommodate a growing foetus and to help push the baby out during delivery.

At the upper corners of the pear-shaped uterus are the fallopian tubes, about four inches long with a tiny passageway as wide as a piece of spaghetti. When the ovary releases an egg, it enters the fallopian tube and is propelled toward the uterus. The ovaries or gonads produce the female hormones, oestrogen and progesterone.

Hormones

When a baby girl is born, her ovaries contain hundreds of eggs which stay inactive until puberty. At puberty, the pituitary gland in the brain starts to produce hormones that stimulate the ovaries to produce female sex hormones, including oestrogen, which develops a girl into a sexually mature woman.

During puberty, girls begin their monthly period and release an egg as part of the menstrual cycle. Approximately once a month, during ovulation, an ovary sends a tiny egg into one of the fallopian tubes. If the egg is not fertilised by a sperm while in the fallopian tube, it dries up and leaves the body about two weeks later through the uterus with a flow of blood and tissues from the inner lining of the uterus. This is the menstrual flow which may last three to five days. A girl’s first period is called menarche.

Chromosomes

When the sperm meets an ovum (egg), an embryo is formed and acquires chromosomes which will determine the sex of the child – XX for female and XY for male. After about six weeks of pregnancy, ovaries develop in females and testes develop in males. Abnormalities in development may be caused by genital defects or hormonal imbalances in the uterus. For example, if the female does not start producing oestrogen, there may be physical defects in the female like a vagina and no uterus.

An XX girl may be exposed to high levels of testosterone in the womb which could lead to the development of an enlarged clitoris or a small penis. If there is an extra X or Y chromosome, sexual differentiation may be difficult. Children may have genitalia ‘in between’ or resemble parts of either sex. If males do not start producing testosterone, abnormalities may result and they may not develop a penis and may resemble a girl even with the XY chromosome.

Abnormalities

Hormonal abnormalities may occur as a girl develops to womanhood. Dr Mark Hill, writing in UNSW Embryology, a publication of the University of New South Wales, describes human genital abnormalities as ‘Disorders of Sex Development’ (DSD) and includes chromosomal, gonadal dysfunction, tract abnormalities, external genitalia and gonadal descent. The previous human sex development terminology for abnormalities such as intersex, psuedohermaphroditism, hermaphrodites and sex reversal are outdated and stigmatising and should be classified as DSD.

If the physical features (such as facial hair, ripped muscles, masculine demeanour) of a female places doubt as to her sex, a sex test or gender verification test can be done to authenticate the sex. The question, why not just a physical, strip test to check the genitals? The answer is gender verification test is necessary because ‘gender’ goes beyond genitals with hormones playing a huge role in defining sex.

Sex tests

Sex hormones tests measure levels of the sex hormones, including oestrogen, progesterone and testosterone. Sex hormone tests are ordered to determine if secretion of these hormones is normal. Several different types of tests are used to evaluate the different sex hormones to help diagnose problems or disorders, and to monitor pregnancy.

To determine ‘femaleness’, testosterone levels are ordered to evaluate ambiguous sex characteristics which places doubt as to whether the person is female or male. Testosterone stimulates sperm production (spermatogenesis) and influences the development of male secondary sex characteristics.

Masculine features

Overproduction of testosterone in females, caused by ovarian and adrenal tumours, can result in masculinisation, the symptoms of which include cessation of the menstrual cycle known as amenorrhoea, imbalance of masculine features and excessive growth of body hair (hirsutism) (www.lifesteps.com).

Sex testing or gender verification is done on sportswomen who look like or perform as men. According to The Times, ‘suspect athletes’ will have their external appearance assessed by experts who will test their sex hormones, genes and chromosomes. According to DollyMix, all these tests sound pretty humiliating to say the least, but it does raise the question: how can it be so hard to tell? (http://www.dollymix.tv/)

Intersex Information and definition

Inter-sex
There was a time not so long ago when parents couldn’t answer the question “Boy or girl?” until a child was born. But nowadays, most people expect parents to be able to answer that question well before birth. That makes things even more awkward for parents whose children have an intersex condition.
When a child is born with an intersex condition, even though the doctors and parents may have thought they knew what sex the child was from prenatal sonograms, the sex of the child may be unclear. There may be several days of tests before doctors and parents decide what gender to assign such a child.
“Intersex” is a general term used for any form of congenital (inborn) mixed sex anatomy. This doesn’t mean that a person with an intersex condition has all the parts of a female and all the parts of a male; that is physiologically impossible. What it does mean is that a person with an intersex condition has some parts usually associated with males and some parts usually associated with females, or that she or he has some parts that appear ambiguous (like a phallus that looks somewhere between a penis and a clitoris, or a divided scrotum that looks more like labia). It’s important to understand that intersex doesn’t always involve “ambiguous” or blended external sex anatomy. Sometimes a child or adult who is intersexed can look quite unambiguous sexually, although internally their sex anatomy is mixed. This happens, for example, with complete androgen insensitivity syndrome, where a person has some male parts (including a Y chromosome and testes) internally, but is quite clearly feminine on the outside. It’s important to also be clear that intersex is different from transgender in that a person with intersex is born with mixed sex anatomy, where as a person who is transgendered is a person who feels himself or herself to be a gender different than the one he or she was assigned at birth. Some people who are transgendered were born intersexed, but most were born with “standard” male or female anatomy.
When a baby or child is recognized to have an intersex condition, it can be quite traumatic for the parents. Parents want their children to have happy, “normal” lives, and they worry that a child with intersex cannot do so. All parents imagine their children’s futures, and parents of children with intersex conditions can have a very hard time doing that; they’re not sure whether to imagine that child will marry, whether the child will give them grandchildren. As a consequence, the parents’ identities also become confused and uncomfortable.
This is why people like me who advocate for the rights of people born with intersex conditions also actively advocate for the rights of their parents. Too often, because some well-intentioned medical professionals dealing with intersex hope to provide a “quick fix,” parents’ persistent confusion and distress is not adequately addressed. Yet parents in such situations obviously deserve the best care available, including professional psychological and social services. They also deserve help finding other parents who have been through the same thing. Parents I’ve talked with tell me that being able to talk with another parent immediately reduced the amount of stress and confusion they felt, and enabled them to focus on the joy of having a beautiful (and often perfectly healthy) baby.
Unfortunately, until recently, the dominant medical system for treating intersex treated parents as a means to an end. Psychologist John Money at Johns Hopkins University developed that system which assumed gender is all a matter of nurture, not nature. Money claimed that any child could be turned into any gender as long as the parents believed in the assigned gender. As a consequence, doctors told parents of children with intersex what gender a child was and then doctors scheduled intensive “normalizing” surgeries to try to make the genitals look clearly female or male (usually female). Confusion and distress on the part of the parents and child were downplayed, because doctors believed the only real issue was the gender assignment, and that once gender was assigned and sex “assignment” surgeries were started, they had to stay the course no matter what. They assumed a clear gender identity would alleviate all parental distress and therefore all distress on the part of the child, and that “normalizing” procedures would provide a clear gender identity.
Money claimed to prove this system worked with a case known as “John/Joan.” After a pediatrician accidentally destroyed the penis of an identical twin boy (who was not intersexed) during circumcision at eight months, Money recommended to the parents that the child be made into a girl. They decided to take his advice and for years Money claimed the sex reassignment had worked. We now know that that child, who grew up to take the name David Reimer, was never happy as a girl. John Colapinto tells his story–including his attempts to rebuild what he could of the male anatomy that was taken from him in “reassignment” surgeries in the book As Nature Made Him.
What, then, should parents of a child with an intersex condition know? The first thing they should know is that “ambiguous genitalia” are not diseased. They just look different. Unusual genitalia may signal an underlying metabolic concern, like Congenital Adrenal Hyperplasia (CAH), but doctors can usually treat metabolic concerns without doing surgery on the child’s genitalia. Many babies born with intersex conditions are perfectly healthy and do not require any medical intervention other than diagnostic tests. Parents therefore need to press doctors to make clear to them which parts of their child’s anatomy involve threats to their child’s physical well-being, and which are psycho-social concerns. They should also press doctors to explain which interventions must be done on an emergency basis (for example, when a child is born without any urinary opening) and which can be put off until parents have had the time to calm down, to get to know their own baby and other parents in similar situations, and to explore all of their options. They also should actively request referrals to professional and peer counselors, so that they can express, in a supportive and unhurried environment, their own feelings of confusion, grief, shame, and fear.
Parents should also know that doctors are likely to seek from them consent for “normalizing” genital surgeries when the child is still very young, because many doctors believe that this will make the parents’ distress end and will prevent the child from feeling any distress. In fact, these surgeries carry great risks, including risks to genital sensation (which the child will need later for a healthy sex life), continence, fertility, and life. The risks should not be downplayed, particularly in consideration of the fact that “normalizing” surgeries are not medically necessary for physical well being. A nurse told me recently of one baby girl who ended up in intensive care on a ventilator because of complications from an elective “normalizing” surgery. Many parents have expressed to me disappointment in the surgeries after having discovered that the surgeries can’t really give their child “normal” looking genitals. Some surgeries require that parents do follow-up care that parents may find very troubling. For example, “vaginoplasties” which lengthen or build vaginas out of skin or pieces of colon often require that parents regularly dilate the new vagina with a lubricated dildo. Several mothers have told me that, if they had understood that that was what would be involved in home follow-up care, they would have waited until their child was old enough to consent to and do the dilations herself. Parents also need to know that the few follow-up studies available show that “normalizing” genital surgeries done in infancy or early childhood seem to have a poor long-term success rate. That is why more and more doctors are recommending that parents put off these surgeries until puberty, when the surgeries tend to be more successful and when children can provide input on the decision-making process. It is also why parents should press doctors to explain to them exactly what scientific follow-up studies can or can’t tell them about the success of these interventions.
Parents should also be aware that legal scholars have recently shown that parents of children with intersex conditions are often not fully informed before they consent to “normalizing” surgeries. In the recent past they have not been told, for example, that the claim that gender comes from nurture has fallen into serious question, and that doctors cannot actually know what gender a child will end up feeling. As a consequence some parents have consented to have their micropenis boys turned into girls, only to discover later that studies by Dr. William Reiner at Johns Hopkins University have shown that many children born with micropenis ultimately take on the male gender identity regardless of having been raised as girls with surgically “feminized” genitalia. Parents have also not been adequately informed about which procedures were essentially elective. Finally, parents have not been advised of what was and was not known about the long-term effects of this system of treatment.
It is important that parents of children with intersex conditions press doctors to tell them the exact diagnosis once the doctors know it. This will enable the parents to do their own research, and to find other parents with similar experiences, as well as understand their options. Parents of children with intersex conditions–indeed, parents of any child with a complex condition–should ask for copies of the child’s medical records on a regular basis. According to an article in December 2001, in the British Medical Journal, “a paternalistic policy of withholding the diagnosis is still practiced by some clinicians” in intersex cases. These physicians mistakenly believe that shielding parents from exact diagnoses in intersex cases protects parents and children from unnecessary harm. A few also mistakenly believe this practice is ethical and legal; it is neither.
A recent article in the British Journal of Urology notes that photographs taken of them as children and later published in medical journals and textbooks have unintentionally harmed some people with intersex conditions. Parents should guard against unnecessary photographing of their children as well as unnecessary display to medical students and residents, particularly as the child becomes old enough to understand and remember these incidents. While teaching hospitals will be inclined to use the opportunity of caring for a child with intersex for educational purposes, parents should resist any encounter that does not directly benefit their child, given the risks. The trauma to parents and child that can arise from repeated display of a child’s genitalia to strangers should not be underestimated.
When facing the possibility of intersex, parents should know that every child can and should be assigned a gender as boy or girl and that doing so does not require any surgery. Gender assignment is accomplished for every child (intersexed or not) through the social and legal labeling of a child as boy or girl. In intersex cases, doctors and parents can work together to try to figure out what gender a child is likely to feel given that particular child’s anatomy and physiology, given what doctors know from scientific studies of outcomes in similar cases, and given how the parents see that child’s gender. The parents will have to recognize that there is a small but real chance that gender assignment may not hold, that the child may express the other gender later, and that this is why it is best to leave the child’s anatomy intact as much as possible. Removing parts doesn’t remove the possibility that the child may change gender later; it only makes it a lot harder for the child to do what she or he wants or needs later.
When parents are making decisions on behalf of a child with intersex, they should keep in mind what the sociologist Suzanne Kessler has shown: Kessler asked a group of men whether, if they had been born with “micropenis,” they would have wanted to be turned into girls, and she asked a group of women whether, if they had been born with large clitorises, they would have wanted to have their clitorises surgically shortened. The vast majority of men said they would rather grow up with micropenis than as girls. The vast majority of women said they would have wanted to have their large clitorises left alone. But asked what they would choose for a child in the same situation, many said they would opt to turn micropenis boys into girls and would opt for cosmetic surgeries on girls’ large clitorises. The reason behind the different answers is the compassion we all feel for children. We all want to protect children from hardship. But the key to keep in mind is what the child would likely want for himself or herself. Kessler’s study as well as interviews with adults with intersex (both those who were subject to “normalizing” surgeries and those who were raised without “normalizing” surgeries) indicates that the vast majority of people want their parents to let them decide for themselves whether to risk health, appearance, genital sensation, continence, fertility, and life. Putting off the surgeries until at least puberty allows the child to have input on the decision, and it seems to provide for better outcomes as well as providing for the possibility that surgical techniques and outcome data will improve in the interim.
Finally, parents should know that intersex does not have to be treated with shame and secrecy. The social (and sometimes also the medical) system by which we treat parents of “different” children as pitiful or shameful is a system that harms those parents and children. Intersex is a natural variation–we see it in all animal species and throughout history. People with intersex can grow up as healthy boys and girls, men and women. Their best shot at doing so is when their parents are not made to feel ashamed of themselves or their children. Unfortunately, “normalizing” procedures like cosmetic genital surgeries sometimes inadvertently make parents and children feel unnecessary shame. Many adults I know with intersex conditions feel that their parents’ decision to change their genitals for cosmetic reasons means that their parents saw them as freaks, even though that isn’t what their parents intended. Dealing openly with intersex is the best defense against the shame-game. Parents should therefore have access to professional and peer support as they learn to talk with their child about intersex in an open, honest, and accurate manner. Parents will also find that connecting their child to peers with intersex will allow their child another opportunity to talk openly about the challenges of living with intersex. Talking this through undoes the shame and secrecy that pretty much everyone involved agrees has historically been the most harmful aspect of intersex.
No one is suggesting that in cases of intersex we “do nothing.” But parents need to know that intersex is primarily a psychosocial concern, and that it is therefore best treated with substantial and continuous psychosocial support, professional and peer. The bottom line is that children with intersex conditions and their parents deserve honesty, respect, and support. But we are not yet at the point where that is automatically provided. We all need to do our part, as doctors, parents, neighbors, and teachers, to demystify intersex and see to it that parents of children with intersex conditions know the same pride and joy of parenting as others.