Separated at birth – controversy over surgery performed on children with ambiguous genitalia – Brief Article

Robrt L. Pela

When Cheryl Chase was born, doctors told her parents she was a boy. Eighteen months later, after judging her genital appendage inadequate as a penis, a different set of medical experts performed a clitoridectomy on Chase and told her parents to raise her as a girl.

“This sort of genital mutilation scars people for life and takes away almost all normal sexual sensation,” says Chase, the 41-year-old director of the Intersex Society of North America. “My clitoris was removed because someone decided that I’d be unhappy as a male with a small penis or as a woman with a giant clitoris. So they cut off part of my body. “

After years of silence intersexes — those born with genitalia that fall somewhere between male and female — are organizing against medical professionals who they claim are performing unnecessary surgery on children with ambiguous or unusual genitalia. Intersexual activists have been attending national gay roundtables, and groups with names like Hermaphrodites With Attitude and Transexual Menace have targeted physicians who advocate and perform these surgeries. Articles in Newsweek and The New York Times and segments on Dateline NBC and ABC’s PrimeTime Live have given the issue of intersexuality a higher profile, and many gay rights groups have begun to acknowledge the correlation between these surgeries and homophobia.

“The underlying principle with these surgeries is to make sure every kid possible gets to grow up to be heterosexual,” says Riki Wilchins, executive director of the New York City-based Gender Public Advocacy Coalition. “Doctors will tell you if they cut away at the child’s genitalia, it can function normally. What they mean is that the kid can function as a normal heterosexual child.”

Wilchins contends that parents can learn to love a child who is physically different, but some medical professionals disagree. “Parents want a girl or a boy, not an it,” says former U.S. surgeon general Joycelyn Elders, an outspoken proponent of gender-assignment surgery. “These activists will tell you that I advocate genital mutilation. I don’t. I support the treatment of children with correct sex identification via medication or surgery. I give the parents as much information as I can and help them decide. “

Chase and other activists have targeted Elders, whose recent public appearances have been leafleted by ISNA members. When Elders addressed the Mautner Project for Lesbians With Cancer fund-raiser in Washington, D.C., September 20, intersexual activists handed out fliers saying that Elders supports intersex genital mutilation. Chase says her group has attempted, unsuccessfully, to discuss the issue with Elders in person.

Elders, who claims she was unaware of a demonstration at the Mautner fund-raiser, is not alone in her beliefs. Kenneth Glassberg, director of pediatric urology at the State University of New York Health Science Center at Brooklyn, believes that “letting an individual decide his or her own sex, when older, is too great a burden. Teenagers already have enough difficulty figuring out who they are; we don’t want them to have to decide which gender they are.

“Intersex surgeries have changed over the past 25 years,” Glassberg continues. “Adults who are objecting to the treatment of intersexual disorders are basing their opinions on surgeries performed many years ago. In the rare case of an intersexual adult’s not being able to identify with the sex he or she was assigned, in most cases the patient was n t taking his or her prescribed medications — medications that must be taken for life.”

Angela Moreno, a 25-year-old whose clitoris was amputated when she was 12, says she’s heard it all before: “My surgery didn’t take place in the Dark Ages. The doctors told me that I had cancer and needed surgery. When I woke up, my clitoris was gone. They’d cut it off because they thought it was too large. No one ever discussed my diagnosis with me. “

Stories like Moreno’s have affected the way some doctors perceive the need for intersexual surgery. Charmian Quigley, a pediatric endocrinologist at Indiana University, says she’s changed her position on the treatment of intersexuality after listening to people who as children had their genitalia surgically altered. “Now I’m less likely to refer a patient for the typical surgical repair,” she says. “We shouldn’t take away tissue we can’t replace and do things that can’t be undone. “

Children should be labeled with a sex says Chase, but that label should not be surgically enforced. “Labeling a child a girl does not require a clitoridectomy,” she says.

Elders, who has been quoted as saying, “I can’t make a good boy, but I can make a pretty good girl,” believes a child isn’t equipped to make such a decision. Glassberg agrees: “There are rare mistakes in gender assignment. For the most part we are making the correct gender assignment and reconstructing genitalia in infancy so that cosmetically they appear as normal boys or girls and can function satisfactorily as adults in the gender assigned.”

Not so, according to Chase. “We don’t try to alleviate the social ill of racism by forcing everyone to be white by lightening their skin at birth,” she says. “But it’s current medical policy to inflict mental and physical harm on anyone who is born differently gendered.”

It’s all about homophobia, says Chase, who points to statistics showing that intersexual children are more likely to grow up gay than a child born with unambiguous genitalia. “Doctors forward the belief that a child sent home from the hospital with a giant clitoris can’t be loved or might turn out to be homosexual,” she says. “Parents are told that performing genital surgery will ensure that their child grows up heterosexual. But all it ensures is that we’ll grow up scarred and ashamed of who we are.”

COPYRIGHT 1997 Liberation Publications, Inc.

COPYRIGHT 2004 Gale Group

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