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07/27/2018

Fix Your Hearts, Not Their Parts

by Jenji Learn, MA

“Fix your hearts not our parts!”

”Autonomy, not surgery, my body belongs to ME!”

“Children have rights!”

Those were the pleas of the large gathering of Intersex people that assembled outside of Lurie Children’s Hospital in Chicago last Thursday, along with their families, friends, supporters, and Transex/Transgender allies, to voice their one, simple demand: “Stop mutilating us. End the genital mutilation of Intersex infants.”

Photo by Jenji Learn

Lurie Children’s Hospital (Chicago) is one of the many hospitals in America in which, when a child is born with mixed genitalia or has other pronounced mixtures of male and female morphology or genetics, doctors routinely perform unnecessary genitoplasty procedures on these infants, who often grow up suffering from physical and emotional harm as a result. The surgical goal is to “make them normal” and “assign” them a binary sex-category of male or female. As much as 1.7%of the population, not even counting the recent findings about the epigeneticand neurophysiologicalmarkers of Transsex/Transgender), are born into this situation.

You can hear their stories for yourself by viewing this link to a video of the rally.

Many of the victims who  spoke at the march talked about how the doctors had not even asked their parents for permission, or sought consent under fraudulent pretenses, before wheeling them away for genitoplasty. This report by Human Rights Watch(along with the victims’ speeches) outline how doctors decide what sex to ‘assign’ to a child not based on any medical or scientific basis, but rather based on whether they think they can make the childlookthe ‘most normal’ with a penis or a vagina. Sometimes, these procedures are done to little boys who aren’t Intersex, but suffered penile ablatio or other injuries (the most famous case being David Reimer). This ‘assignment’ can sometimes be re-enforced through years of operant conditioning and covert medication with hormones. Some speakers  said they were told that they are Intersex, but also told that nobody would ever have loved or accepted them as they were and their ‘assignment’ was for their own good, and that they will likely never meet another Intersex person and the best thing for them to do is spend their lives hiding.
As a Trans woman born in the 1980s, I’ve heard all of this before. These were the same lies used to frighten and terrify Transgender children from social transition for decades. These are the same fears touted to allow doctors to assume control over the bodies and lives of Transgender/Transsex adults. These are the same excuses that the medical establishment states to justify acting as the arbiters of our identities and forcing women like me to perform to misogynist, paternalistic ideals of femininity in order to gain their approval and permission to access medical care and legal recognition. Despite these “reasons”, medical control over gender and sex hinders Trans people from having a normal childhood and being emotionally healthy.  In a similar manner,  ‘conversion therapies’ for Trans (and Gay) people were developed out of the experimental attempts of men like John Money to ‘assign’ a sex to Intersexchildren and condition them to their ‘proper role’ as either a man/boy or woman/girl. It was Money who authored the first two entries and medical protocols for Trans and Intersex people in the DSM, even though none of it was based in scientific fact.

When doctors take it on themselves to ‘decide’ a child’s sex, sometime, by chance, they get it right, but often they get it wrong. Even if an Intersex child happens to be ‘assigned’ the sex that corresponds to their actual identity and internal sense of self, the fact that her vaginoplasty was performed at such a young age means that she could experience shallow vaginal depth or an increased chance of sexual dysfunction. If the same child turns out to be a boy, then it’s even worse, as it will now be that much more difficult for him to undergo phalloplasty and still achieve full sexual functioning, if that’s what he wants. One protest organizer constructed an art installation of bloody diapers to represent the ‘tiny bodies’ that “receive this as their welcome into the world”. Another said in private that he would have liked to have brought a sign that simply read “Why did you chop off my dick?”.

Photo by Jenji Learn. This art installation of bloody diapers, a common sight after these surgeries, is meant to represent ‘the welcome we give these children to the world

These risks are part of why, contrary to popular misconception, Trans patients are not able to access these procedures until they are fully-grown adults (and even then, often face obstacles through discriminatory insurance practicesas I’ve discussed in this space before). Consider the double-standard. Consenting Trans adults are often told we are not fit to make decisions about our own bodies. Parents who allow their Trans teens to request and access hormone-blockers (the effects of which are reversible) get accused of ‘abuse’by some. Yet the same people who deny us have no compunction about turning around and forcingthe same medical interventions on a helplessinfantwho can’t possibly consent, or yet know whether they have a clear sense of themselves as male, female, neither, or both.

Photo by Jenji Learn. The two youngest members of InterAct, a national Intersex advocacy group

The nearly automatic practice of surgically assigning genitalia to children is an exercise in denying present autonomy to parents and future autonomy to the people these infants will be. In fact, the medical establishment has a history of denying autonomy in Trans people. As we transition, we face overwhelming and degrading obstacles in having to “prove” who we really are. For example, Trans adults are required by the DSM to spend a yearin intensive psychotherapy proving that they aren’t ‘confused’ before they are even allowed a prescription for hormones. At the same time, altered Intersex children who have not given assent for their surgery are forced to take hormones. Health care providers who are reluctant to give a Trans teenager access to drugs (with reversible effects) that delay some of the secondary effects of puberty, will turn around and endorse performing arbitrary genitoplastyon infants who don’t fit into their ideals of what sexed embodiment ‘should’ be.

Transgender/Transsex people are psychopathologized.  Fears and insecurities about the complexity and variability of sex and sexuality are no excuse for surgically altering children who remind people that the world is as they would like it to be. In the case of Intersex children, we are literally cutting out what makes them different in order to fashion them into something that others are more comfortable with, without regard to the child’s comfort or well-being; their humanity or autonomy.

As long as the medical establishment and public-at-large continue to see sex as a unitary, uniform and mutually exclusive category, Intersex children will continue to be harmed and mutilated. We must remember that Intersex children are the most visible reminder that the ideology of the sex-gender binary is an unscientific view. The desire of these doctors (and sometimes, parents) to make their child not-Intersex through needless surgeries, or to make someone not-Trans through sustained psychological abuse, suggests a denial of nature and lived reality, though not by us.

As one of the Intersex victims said in their rally testimonial, pleading to the walls of the institution that maimed him: “We do not suffer from being Intersex. We suffer from how you treat us!”

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