by Curtis E. Hinkle
We are no longer called hermaphrodites. We are no longer called intersexed. We are all men and women with disorders of sex development according to many of the medical experts who have managed our lives over the past decades. We now have a new Consortium for the Management of Disorders of Sex Development and they are proposing to manage the lives of future children born with this disorder. What are the risks involved with this change in terminology? I think there are many.
Is intersexuality normal? No. However, it is totally natural and not life threatening in most cases. There are so many different phenomena in our natural world that are not normal. Our world is filled with people who are not normal in one way or another. However, what criteria do we use to judge whether these natural phenomena are disorders or not? What criteria do we use to determine if a natural variation in the human population is good, bad or neutral? I don’t have the answer to these questions because there seems to be no precise answer. It varies with the person making the judgments. I feel that there are two main questions to ask before judging behaviors, variations and other phenomena in the natural world. Are they harmful to society and if so why? Do they pose a serious risk to the individual and if so why? If the reason for the risk to the individual is simply society’s reaction to the issue and not any real threat to that society, then is it the individual who should be deemed disordered or the reactions of those judging the individual? I think that it would be most likely that the problem is within the one judging the individual, not the individual being judged.
Now that the managers of disorders are ready to start treating children with these disorders of sex development, I have a few questions about how this pejorative terminology will actually be explained to the child and the consequences of such pathological views that will be used to explain not only the physical sex of the child but the implications this will have on all aspects of the child’s life associated with sex, those being their gender identity, gender role, sexual orientation and actual health needs.
Once a parent is told that their child has a disorder, they most likely will assume there must be some treatment to either cure or manage this disorder. The consortium is not holding out a cure because this is not something that can be cured or needs to be cured in my opinion. However, they will become managers along with the parents. Are they becoming managers just of the child’s body which is the initial reason for the diagnosis? No, they are becoming managers of all aspects related to sex in the child’s life, their gender and their orientation. What starts out as a physical disorder to be managed is now viewed as a possible psychological problem with other disorders that could become evident if the child does not comply with the gender imposed and also we have the undercurrent of homophobia. Some of these managers may inform the parent that their child is more likely to be homosexual as a result of the disorder which could make a lot of parents think that the homosexuality is also a disorder, part of the original diagnosis when told their child has a disorder of sex development.
There are many people who do believe that homosexuality is a disorder and they are involved in research to prove it. They may not use the word “disorder” at this time but when links are made with intersexed children, it would be much easier to introduce this concept of homosexuality being a disorder also. Once you decide that certain variations of sex development are disorders, then most behaviors closely connected with that group could be viewed as part of that disorder.
When would a manager of the child’s disorder reveal to the patient that they had a disorder of sex development? How could this be done in such a way that the child does not feel that puberty, identity and other essential aspects of their lives would not be disordered also? I don’t think there is. The very term “disorder” implies that compliance with the protocols will be essential not to be disordered, not to have a disorderly life and that the managers are the only ones who have the solution. But they are not living in the body of the child. They are not living in the mind and heart of the child. Children do not have the words or the experience to understand sex, gender and orientation.
When speaking with children, one needs to keep it simple. This is why I like Dr. Hazel Beh’s and Dr. Milton Diamond’s suggestion that we use the term variation. It is easy for a child to grasp that boys and girls come in all varieties. They can look around them and see that there are all kinds of boys and girls but that each kind or variety is not necessarily a bad thing or a good thing. We are just all different. What is damaging to a child is to feel that they are not just a different kind of boy or girl but that they are a disordered or defective boy or girl. This has very serious implications for the child and could make their future development even more stigmatic and traumatizing while interacting with those in control of their bodies.
Every feeling the child has could be internalized as part of the disorder and something else that needs management and which is shameful. Not feeling like other boys or girls, not looking like other boys or girls and not having a sexual orientation that is like most other boys or girls could be and most likely will be interpreted by the child as part of their original diagnosis, part of their disorder of sex development.
Welcoming children into our lives is a wonderful gift for many of us. Watching them grow and holding out a helping hand not only enriches our lives but builds character and strong bonds which overall helps society as a whole. Let’s give intersexed children the assistance they need to live in a world that does not understand them and make sure we do not simply manage them and further damage them with pathological, pejorative terms which make them not only feel different but defective and defective in one of the most essential parts of what our society has deemed all people must be to be fully human – their sex.
Monday, September 15, 2008
Wednesday, August 13, 2008
Some problems with the new terminology for intersex
by OII's Advisor on Biosex Variations, M. Italiano, M.B.B.S. (A.M.)
© 13 July 2008
I think that the term DSD is a problem for a few reasons. Traditionally, sex development was the third of a group of three classifications of defining sex criteria in general. Sex determination was the first and was involved in describing genetic factors which were determinative, i.e. involved in determining sex. Sex differentiation was the second and involved gonadal sex, describing a process which results in differing (but complementary) gametes. The third was sex development. Development meant the process with which phenotypic sex characteristics (genitalia, bodily habitus) would be active (male development) or "lack" development by "default" (female development). Thus, when so-called disorders or so-called anomalies were described in most texts, they would be divided into those of sex determination if it involved genetic sex, sex differentiation if it involved gonadal sex, and sex development, if it involved phenotypic sex. I believe that with the "catch all" term of “development” in DSD, we have minimized the importance and understanding of the processes of both determination and differentiation. In an individual with Swyer's Syndrome, who would be classified as having an XY DSD, if they lack the SRY testis determining gene, we can't easily describe their female phenotype as disordered (lacking order), since we would typically expect a female phenotype in the absence of this gene. If the deletion extended and included a deletion of more of the Y chromosome, it becomes unclear as to whether this individual would be put in a classification of Swyer's (an XY DSD) or Turner's (which is a "chromosomal DSD"). Again, by placing all cases of intermediate sex into a category of "development", we have downplayed the factors of both determination and differentiation. One of the head authors of the Consensus has indeed changed the word development to differentiation.
http://www.ncbi.nlm.nih.gov/pubmed/18574210?ordinalpos=3&itool=EntrezSystem2 .PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
(Notice also, the substitution of the word "sex", with the word "sexual", which may further compound the issue).
Secondly, in addition to leaving out in the descriptor, determination and differentiation, there is a further difficulty which I see in the use of the term DSD in the way it is suggested in the Consensus statement. I believe that the use of terms such as "XX DSD" or "XY DSD" is insulting, very much like using the terms female pseudohermaphrodite and male pseudohermaphrodite. Many children even know that XY is used to refer to male and XX to female. For an XY CAIS phenotypic female to learn she has an "XY DSD", is basically to call her a "male”, if even more covert sounding than a "male pseudohermaphrodite". In this regard, the TYPES of classifications of DSD have also received criticism, which I believe is well justified.
http://www.ncbi.nlm.nih.gov/pubmed/17934671?ordinalpos=35&itool=EntrezSystem 2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
A third problem I see with using DSD is that that the word “development” is used
a) as a long-term span definition and
b) that it is used to describe personality, behavior, cognitive thought processes, and a notion of a prescribed expectation.
For instance, there are countless reports on intersex, which refer to individuals who have not met "DEVELOPMENTal milestones". These milestones, for the most part are expectations which have been measured and ascribed to persons and samples, which consist largely of persons or groups of persons who would not be classified as having a "DSD". This has the potential for abuse, in that it can easily be used to shift the domain of people who have a "DSD" to that of psychiatry and clinical psychology, whereby the individual is then further labeled with a mental disorder. In what way can we reasonably expect milestones, such as social skill development and body image development to occur in a phenotypic female with 5 Alpha reductase 2 deficiency who at puberty virilizes, or an individual with 46 XX CAH and ambiguous genitalia who has the co-existence of phenotypic masculinizing and feminizing characteristics? The temptation to psychopathologize is so great, that I wonder if indeed this was not part of what went in to the formulation when the word “development” was used. It seems to me that special legal measures should be implemented to protect individuals who "have a DSD" from any attempts by professionals to "cross-pathologize" such individuals with a mental disorder based upon psycho-social developmental processes. Insurance companies should be prohibited from using information for coverage benefits. For peer support, I do not think it is helpful for someone with CAIS (or other conditions usually presenting after puberty) to mobilize for or against "justifying" the psycho-social developmental milestones of those with a "DSD" which have earlier manifestations on body image and social interaction. Lastly, the term development is often used in regards to psychosexual or gender development. No studies have correlated basal brain area biology to gender outcomes in "DSD". Law should respect science, so that a physician needs to provide in writing that the assignment may not match psychosexual or gender outcome. A license is to protect the public, the consumer, not the professional. My next article will be why disorder is not a good term.
© 13 July 2008
I think that the term DSD is a problem for a few reasons. Traditionally, sex development was the third of a group of three classifications of defining sex criteria in general. Sex determination was the first and was involved in describing genetic factors which were determinative, i.e. involved in determining sex. Sex differentiation was the second and involved gonadal sex, describing a process which results in differing (but complementary) gametes. The third was sex development. Development meant the process with which phenotypic sex characteristics (genitalia, bodily habitus) would be active (male development) or "lack" development by "default" (female development). Thus, when so-called disorders or so-called anomalies were described in most texts, they would be divided into those of sex determination if it involved genetic sex, sex differentiation if it involved gonadal sex, and sex development, if it involved phenotypic sex. I believe that with the "catch all" term of “development” in DSD, we have minimized the importance and understanding of the processes of both determination and differentiation. In an individual with Swyer's Syndrome, who would be classified as having an XY DSD, if they lack the SRY testis determining gene, we can't easily describe their female phenotype as disordered (lacking order), since we would typically expect a female phenotype in the absence of this gene. If the deletion extended and included a deletion of more of the Y chromosome, it becomes unclear as to whether this individual would be put in a classification of Swyer's (an XY DSD) or Turner's (which is a "chromosomal DSD"). Again, by placing all cases of intermediate sex into a category of "development", we have downplayed the factors of both determination and differentiation. One of the head authors of the Consensus has indeed changed the word development to differentiation.
http://www.ncbi.nlm.nih.gov/pubmed/18574210?ordinalpos=3&itool=EntrezSystem2 .PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
(Notice also, the substitution of the word "sex", with the word "sexual", which may further compound the issue).
Secondly, in addition to leaving out in the descriptor, determination and differentiation, there is a further difficulty which I see in the use of the term DSD in the way it is suggested in the Consensus statement. I believe that the use of terms such as "XX DSD" or "XY DSD" is insulting, very much like using the terms female pseudohermaphrodite and male pseudohermaphrodite. Many children even know that XY is used to refer to male and XX to female. For an XY CAIS phenotypic female to learn she has an "XY DSD", is basically to call her a "male”, if even more covert sounding than a "male pseudohermaphrodite". In this regard, the TYPES of classifications of DSD have also received criticism, which I believe is well justified.
http://www.ncbi.nlm.nih.gov/pubmed/17934671?ordinalpos=35&itool=EntrezSystem 2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
A third problem I see with using DSD is that that the word “development” is used
a) as a long-term span definition and
b) that it is used to describe personality, behavior, cognitive thought processes, and a notion of a prescribed expectation.
For instance, there are countless reports on intersex, which refer to individuals who have not met "DEVELOPMENTal milestones". These milestones, for the most part are expectations which have been measured and ascribed to persons and samples, which consist largely of persons or groups of persons who would not be classified as having a "DSD". This has the potential for abuse, in that it can easily be used to shift the domain of people who have a "DSD" to that of psychiatry and clinical psychology, whereby the individual is then further labeled with a mental disorder. In what way can we reasonably expect milestones, such as social skill development and body image development to occur in a phenotypic female with 5 Alpha reductase 2 deficiency who at puberty virilizes, or an individual with 46 XX CAH and ambiguous genitalia who has the co-existence of phenotypic masculinizing and feminizing characteristics? The temptation to psychopathologize is so great, that I wonder if indeed this was not part of what went in to the formulation when the word “development” was used. It seems to me that special legal measures should be implemented to protect individuals who "have a DSD" from any attempts by professionals to "cross-pathologize" such individuals with a mental disorder based upon psycho-social developmental processes. Insurance companies should be prohibited from using information for coverage benefits. For peer support, I do not think it is helpful for someone with CAIS (or other conditions usually presenting after puberty) to mobilize for or against "justifying" the psycho-social developmental milestones of those with a "DSD" which have earlier manifestations on body image and social interaction. Lastly, the term development is often used in regards to psychosexual or gender development. No studies have correlated basal brain area biology to gender outcomes in "DSD". Law should respect science, so that a physician needs to provide in writing that the assignment may not match psychosexual or gender outcome. A license is to protect the public, the consumer, not the professional. My next article will be why disorder is not a good term.
Friday, August 8, 2008
Ambiguous Medicine and Sexist Genetics: A Critique of the DSD Nomenclature
This summary is not available. Please
click here to view the post.
Thursday, July 17, 2008
THE SCIENTIFIC ABUSE OF GENETICS AND SEX CLASSIFICATIONS
Available in PDF: Click here
By M. Italiano, M.B.B.S. (A.M.), Advisor on Biosex Variations, Organisation Intersex International
© July 17, 2008
It is a common misconception amongst many professionals and non-professionals alike, that the so-called “sex chromosomes” determine one’s sex. Typically in humans, there are 23 pairs of chromosomes with a total number of 46 chromosomes. Twenty two pairs are called autosomes and one pair is called sex chromosomes. They were designated as such because the pair found in males and females typically differed. Males usually had one X and one Y chromosome and females usually had two X chromosomes. Thus, it was believed that X and Y chromosomes determined sex, and that the autosomes (all the other “chromosomes”) determined non-sex physical characteristics.
However, correlation does not equal causation. There are actually more genes on the autosomes, and not the so called “sex chromosomes”, which are involved in sex determination (and sex differentiation and development), than there are on the so-called sex chromosomes. In fact, a gene on the Y chromosome (SRY) is one of the few genes on this chromosome which even has a role in sex determination, and its role in sex determination is indirect. It turns on genes on other chromosomes which more directly determine sex. The X chromosome also contains only a few genes which have a role in sex determination, but again, often in a very indirect way, through regulating autosomal sex genes (not on the “sex chromosomes”) which directly determine sex. In fact, almost all of the X chromosome genes are inactivated on the second X chromosome in XX individuals, making XX and XY individuals roughly equal in X chromosome gene expression. As the X chromosome is necessary for survival, it becomes clear that the X chromosome is not a female chromosome. Furthermore, the X and Y chromosomes pair during gametogenesis and exchange chromosomal material with each other in a process called crossing over. As a result, part of an individual’s X chromosome was part of a Y chromosome, and part of an individual’s Y chromosome is part of an X chromosome. These areas are known as pseudoautosomal, mainly because the “sex chromosomes” are labeled as such.
There are in fact sex determining genes on many of the chromosomes, making the term “sex chromosomes” as such a misnomer. In the presence of an XX chromosome type with no Y specific chromosomal genes, an embryo still can become a male with testes, a penis, prostate, with no female organs, and the testes can initiate spermatogenesis (1). Likewise, in the presence of an XY chromosome pattern, with totally normal X and Y chromosomes, an individual can still become a female, with ovaries, a uterus, Fallopian tubes and a vagina, with no male organs (2, 3). These XY females can deliver a normal baby, both with or even without assisted reproductive technologies (2, 3). This is because genes on the autosomes may still be altered, or even switched on or off in both XX and XY embryos. This can result from environmental stimuli. “Sex chromosomes”, as a label, is neither scientific nor accurate as a term for either or both the X and Y chromosomes.
Thus, referring to either the XX or XY karyotype of an individual as the person’s “genetic sex” is also a misnomer since most genes involved in sex determination are on the autosomes and not the so called “sex chromosomes”. Furthermore, to refer to an XY person as a genetic male or genetically male, or an XX individual as a genetic female or genetically female, is errant and is a rare example of how scientific terminology is misused when compared to other relevant examples. For instance, sex is a phenotype, just as hair color, height, and eye color. Just as it is unscientific to refer to someone as a “genetic tall person” or a “genetically blonde haired person”, it is not scientific to use expressions such as “genetic male”, “genetically female”, or “chromosomally a male” to define an individual’s sex. When speaking about traits which affect individuals who are XY to a far greater degree than those who are XX, it is also unscientific to refer to them as “male limited”. They may be XY limited, but not “male limited”.
Because most sex determining genes are on autosomes, most intersexed individuals have a typical XX or XY karyotype. Thus, to divide intersexed individuals into categories such as XX intersex (now 46, XX DSD) or XY intersex (now 46, XY DSD) is counterproductive and problematic (4). An XX male with unambiguous testes and only male sex organs has virtually nothing in common with an XX female who lacks a uterus. Yet, both would be classified as having a 46, XX DSD. Likewise, an XY female with a uterus, and no male sex organs and who can deliver a baby, has virtually nothing in common with an XY male born with cloacal bladder exstrophy. Yet, again, both of them would be classified as having a 46, XY DSD. To further compound the problem, if someone who has both XX and XY chromosomes (known as XX/XY chimerism or XX/XY mosaicism), were also what was formerly called a "true hermaprhodite" (a case of both ovarian and testicular tissue co-existing in the same individual), that same person would now not only have an “ovotesticular DSD” but also a “chromosomal DSD”. Yet again, this intersexed person would have virtually nothing in common with an anatomically typical and even fertile male or female, who may also be XX/XY (5, 6). Yet this anatomically typical and fertile male or female would now have a “chromosomal DSD”. It doesn’t stop there. There are numerous examples of how this bad science leads to erroneous categorization. For instance, someone can be XY in the blood karyotype, yet be XX in the skin and ovaries and be a fertile female, simply due to blood chimerism caused by a twin fetus brother (6). This person would ostensibly have a “chromosome DSD”, would be misdiagnosed in amniocentesis, or chromosome screening, and although DSD is supposed to represent congenital conditions, this would be an “acquired DSD”, which likewise would be misdiagnosed even in later life.
Forensic science has now realized the error in using “male DNA” or “male genetics” at crime scenes (7). Legal systems are now realizing the same for trying to find “correct” sex for marriage (when actually they would promote same sex marriage by using “sex chromosomes” as decisive, since an XY female who can give birth could be viewed as the opposite sex of an XX female who could also give birth) by using outdated and incorrect “science”. That an XX true hermaphrodite was declared female due to karyotype (8) has been criticized (9) and not followed in subsequent legal practice. Even sports medicine is realizing that “sex chromosomes” or indeed any given “sex gene” is inadequate for “determining” the sex of an athlete (10).
It is time to dismiss mythology as a substitute for scientific knowledge and evidence, and if this requires social and political acquiescence, then so must it be.
REFERENCES
1. Ronfoni L, Bianchi ME Molecular mechanisms in male determination. Cell Mol Life Sci, 2004, 61:1907-1925.
2. Selvaraj K et al. Successful pregnancy in a patient with a 46, XY Karyotype. Fertil Steril, 2002, 78:419-420.
3. Yu, Q et al. The role of sexual related Y gene detection in the diagnosis of patients with gonadal dysgenesis. Chinese Medical J (Eng), 2001, 114:128-131.
4. Hughes, IA et al. Consensus statement on management of intersex disorders. J Ped Urol, 2006, 3:148-162.
5. Schoenle, E, et al. 46,XX/46,XY chimerism in a phenotypically normal man. Hum Genet, 1983, 64:86-89.
6. Sudik, R et al. Chimerism in a fertile woman with 46, XY karyotype and female phenotype. Hum Reprod, 2001, 16:56-58.
7. Von Wumb-Schwark, N et al. What do the X and Y chromosomes tell us about sex and gender in forensic case analysis? J Forensic Leg Med, 2007, 14:27-30.
8. In the Marriage of C and D (falsely called C) (1979) 35 FLR 340.
9. Finley, HA Sexual Identity and the Law of Nullity (1980) 54 ALJ 115.
10. Dickinson, BD et al. Gender verification of female Olympic athletes. Med Sci Sports Exercise, 2002, 34:1539-1542.
By M. Italiano, M.B.B.S. (A.M.), Advisor on Biosex Variations, Organisation Intersex International
© July 17, 2008
It is a common misconception amongst many professionals and non-professionals alike, that the so-called “sex chromosomes” determine one’s sex. Typically in humans, there are 23 pairs of chromosomes with a total number of 46 chromosomes. Twenty two pairs are called autosomes and one pair is called sex chromosomes. They were designated as such because the pair found in males and females typically differed. Males usually had one X and one Y chromosome and females usually had two X chromosomes. Thus, it was believed that X and Y chromosomes determined sex, and that the autosomes (all the other “chromosomes”) determined non-sex physical characteristics.
However, correlation does not equal causation. There are actually more genes on the autosomes, and not the so called “sex chromosomes”, which are involved in sex determination (and sex differentiation and development), than there are on the so-called sex chromosomes. In fact, a gene on the Y chromosome (SRY) is one of the few genes on this chromosome which even has a role in sex determination, and its role in sex determination is indirect. It turns on genes on other chromosomes which more directly determine sex. The X chromosome also contains only a few genes which have a role in sex determination, but again, often in a very indirect way, through regulating autosomal sex genes (not on the “sex chromosomes”) which directly determine sex. In fact, almost all of the X chromosome genes are inactivated on the second X chromosome in XX individuals, making XX and XY individuals roughly equal in X chromosome gene expression. As the X chromosome is necessary for survival, it becomes clear that the X chromosome is not a female chromosome. Furthermore, the X and Y chromosomes pair during gametogenesis and exchange chromosomal material with each other in a process called crossing over. As a result, part of an individual’s X chromosome was part of a Y chromosome, and part of an individual’s Y chromosome is part of an X chromosome. These areas are known as pseudoautosomal, mainly because the “sex chromosomes” are labeled as such.
There are in fact sex determining genes on many of the chromosomes, making the term “sex chromosomes” as such a misnomer. In the presence of an XX chromosome type with no Y specific chromosomal genes, an embryo still can become a male with testes, a penis, prostate, with no female organs, and the testes can initiate spermatogenesis (1). Likewise, in the presence of an XY chromosome pattern, with totally normal X and Y chromosomes, an individual can still become a female, with ovaries, a uterus, Fallopian tubes and a vagina, with no male organs (2, 3). These XY females can deliver a normal baby, both with or even without assisted reproductive technologies (2, 3). This is because genes on the autosomes may still be altered, or even switched on or off in both XX and XY embryos. This can result from environmental stimuli. “Sex chromosomes”, as a label, is neither scientific nor accurate as a term for either or both the X and Y chromosomes.
Thus, referring to either the XX or XY karyotype of an individual as the person’s “genetic sex” is also a misnomer since most genes involved in sex determination are on the autosomes and not the so called “sex chromosomes”. Furthermore, to refer to an XY person as a genetic male or genetically male, or an XX individual as a genetic female or genetically female, is errant and is a rare example of how scientific terminology is misused when compared to other relevant examples. For instance, sex is a phenotype, just as hair color, height, and eye color. Just as it is unscientific to refer to someone as a “genetic tall person” or a “genetically blonde haired person”, it is not scientific to use expressions such as “genetic male”, “genetically female”, or “chromosomally a male” to define an individual’s sex. When speaking about traits which affect individuals who are XY to a far greater degree than those who are XX, it is also unscientific to refer to them as “male limited”. They may be XY limited, but not “male limited”.
Because most sex determining genes are on autosomes, most intersexed individuals have a typical XX or XY karyotype. Thus, to divide intersexed individuals into categories such as XX intersex (now 46, XX DSD) or XY intersex (now 46, XY DSD) is counterproductive and problematic (4). An XX male with unambiguous testes and only male sex organs has virtually nothing in common with an XX female who lacks a uterus. Yet, both would be classified as having a 46, XX DSD. Likewise, an XY female with a uterus, and no male sex organs and who can deliver a baby, has virtually nothing in common with an XY male born with cloacal bladder exstrophy. Yet, again, both of them would be classified as having a 46, XY DSD. To further compound the problem, if someone who has both XX and XY chromosomes (known as XX/XY chimerism or XX/XY mosaicism), were also what was formerly called a "true hermaprhodite" (a case of both ovarian and testicular tissue co-existing in the same individual), that same person would now not only have an “ovotesticular DSD” but also a “chromosomal DSD”. Yet again, this intersexed person would have virtually nothing in common with an anatomically typical and even fertile male or female, who may also be XX/XY (5, 6). Yet this anatomically typical and fertile male or female would now have a “chromosomal DSD”. It doesn’t stop there. There are numerous examples of how this bad science leads to erroneous categorization. For instance, someone can be XY in the blood karyotype, yet be XX in the skin and ovaries and be a fertile female, simply due to blood chimerism caused by a twin fetus brother (6). This person would ostensibly have a “chromosome DSD”, would be misdiagnosed in amniocentesis, or chromosome screening, and although DSD is supposed to represent congenital conditions, this would be an “acquired DSD”, which likewise would be misdiagnosed even in later life.
Forensic science has now realized the error in using “male DNA” or “male genetics” at crime scenes (7). Legal systems are now realizing the same for trying to find “correct” sex for marriage (when actually they would promote same sex marriage by using “sex chromosomes” as decisive, since an XY female who can give birth could be viewed as the opposite sex of an XX female who could also give birth) by using outdated and incorrect “science”. That an XX true hermaphrodite was declared female due to karyotype (8) has been criticized (9) and not followed in subsequent legal practice. Even sports medicine is realizing that “sex chromosomes” or indeed any given “sex gene” is inadequate for “determining” the sex of an athlete (10).
It is time to dismiss mythology as a substitute for scientific knowledge and evidence, and if this requires social and political acquiescence, then so must it be.
REFERENCES
1. Ronfoni L, Bianchi ME Molecular mechanisms in male determination. Cell Mol Life Sci, 2004, 61:1907-1925.
2. Selvaraj K et al. Successful pregnancy in a patient with a 46, XY Karyotype. Fertil Steril, 2002, 78:419-420.
3. Yu, Q et al. The role of sexual related Y gene detection in the diagnosis of patients with gonadal dysgenesis. Chinese Medical J (Eng), 2001, 114:128-131.
4. Hughes, IA et al. Consensus statement on management of intersex disorders. J Ped Urol, 2006, 3:148-162.
5. Schoenle, E, et al. 46,XX/46,XY chimerism in a phenotypically normal man. Hum Genet, 1983, 64:86-89.
6. Sudik, R et al. Chimerism in a fertile woman with 46, XY karyotype and female phenotype. Hum Reprod, 2001, 16:56-58.
7. Von Wumb-Schwark, N et al. What do the X and Y chromosomes tell us about sex and gender in forensic case analysis? J Forensic Leg Med, 2007, 14:27-30.
8. In the Marriage of C and D (falsely called C) (1979) 35 FLR 340.
9. Finley, HA Sexual Identity and the Law of Nullity (1980) 54 ALJ 115.
10. Dickinson, BD et al. Gender verification of female Olympic athletes. Med Sci Sports Exercise, 2002, 34:1539-1542.
Sunday, March 16, 2008
DSD (Disorders of sex development): a sexist, classist ideology based on eugenics
by Curtis E. Hinkle
1) What is sexism?
2) What is eugenics?
3) Who controls the definitions?
4) Who is fit to be born?
5) Is our sex a disorder?
1) What is sexism?
3) Who controls the definitions?
This same group published the following consensus statement on CAH which recommends surgery on intersex infants between 2 and 6 months of age:
Consensus Statement on 21-Hydroxylase Deficiency from The Lawson Wilkins Pediatric Endocrine Society and The European Society for Paediatric Endocrinology (Joint LWPES/ESPE CAH Working Group)
http://jcem.endojournals.org/cgi/content/full/87/9/4048
4) Who is fit to be born?
5) Is our sex, that is intersex, a disorder?
1) What is sexism?
2) What is eugenics?
3) Who controls the definitions?
4) Who is fit to be born?
5) Is our sex a disorder?
1) What is sexism?
Sexism can be considered from different perspectives, both intricately related one to the other, one based on discrimination itself and the other on the division of all humans into legal sex categories which is the fundamental tool used to perpetuate and justify the discrimination.
Discrimination against people which is based on their sex assignment as male or female, instead of their individual merits, is sexist. This discrimination is so prevalent in our societies that it appears natural because we assume that the underlying binary division of all people into male and female is also natural, but it is not. Intersex people prove that it is not and it can be argued rather convincingly that the erasure of intersex as a natural sex variation is a result of the basic sexism which is considered normal in our society. Unfortunately, sexism is "normal" because there are medical and legal norms which justify this sexism. However, the fact that it is "normal" does not mean it is natural.
The most basic form of sexism is the biological essentialism (1) which is used to divide all humanity into just two legal categories - male and female with all deviations defined as pathological and in need of medical intervention to "correct" their sex. There would be no reason to justify this division of all humanity legally and medically into just two categories (2) if we felt there were no fundamental differences between these two categories and there would be no need to pathologize all intersex people as disorders of sex development if this unnatural division of all humanity as male or female were not politically motivated. (3)
2) What is eugenics?
2) What is eugenics?
"Eugenics is the study of or belief in the possibility of improving the qualities of the human species or a human population, esp. by such means as discouraging reproduction by persons having genetic defects or presumed to have inheritable undesirable traits (negative eugenics) or encouraging reproduction by persons presumed to have inheritable desirable traits (positive eugenics)."
Based on the Random House Unabridged Dictionary, (c) Random House, Inc. 2006.
Eugenics has a very tragic, racist, classist history. (4) The nature of eugenics makes it a political ideology based on definitions of people which divide humanity into those who are fit and those who are unfit. The basic problem is that those who control the definitions are those who have political supremacy over disenfranchised populations. Denying the racist, sexist and classist history of eugenics is dangerous if one honestly wants to understand the political motivations behind eugenic movements.
In the 20th Century, abortion has been introduced as a tool for eugenic movements. This is very problematic because the conflation of women's rights with eugenics often obscures the underlying racism, sexism and classism involved in the justification of abortion as a eugenic tool. Both sides of this debate overlook the serious dangers and inequalities of women as a class. The pro-choice debate does not emphasize the lack of most women in the world to make a real choice because they are deprived of that power even when abortion is provided and this can often lead to the elimination of female fetuses. The pro-life debate fails to recognize the need for women to control their own bodies and have the right over reproductive decisions concerning their bodies.
Instead of dealing with the serious oppression of people based on race, sex and class, upper middle-class pro-choice models of abortion as the model for feminism assumes that women who are lacking almost all control of their reproductive rights can benefit from such a model. What can often happen is the choice to eliminate females and all deviations from male and female with only male births being favored. (5)
3) Who controls the definitions?
Those in charge of the definitions which determine who are male and female and whose sex is a genetic defect is a group of predominantly, Euro-centric male medical experts: the Lawson Wilkins Pediatrics Endocrine Society along with Eric Vilain and Alice Dreger both associated with the Intersex Society of North America (ISNA). This is the group which is responsible for the Chicago Consensus Statement on Management of Intersex Disorders which redefined intersex as a genetic defect and recommended the new "disorder" terminology with "intersex" being replaced by "disorders of sex development". (6)
This same group published the following consensus statement on CAH which recommends surgery on intersex infants between 2 and 6 months of age:
Consensus Statement on 21-Hydroxylase Deficiency from The Lawson Wilkins Pediatric Endocrine Society and The European Society for Paediatric Endocrinology (Joint LWPES/ESPE CAH Working Group)
http://jcem.endojournals.org/cgi/content/full/87/9/4048
4) Who is fit to be born?
Those who are closest to the ones who control the definitions. Let's be honest and stop trying to justify racism, sexism and this abuse of power over us just because those in charge of the definitions are powerful and have great influence around the world. We are not fit to be born because we do not look like them; we do not act like them and we are a threat to their two-sex system which keeps them in a privileged position. They are "fit" simply because they control the definitions of who is fit.
5) Is our sex, that is intersex, a disorder?
We in OII firmly reject the idea that our sex is a disorder and we therefore reject the pathological definition of our sex as a "disorder of sex development" or DSD. The real danger and disorders are the racism and sexism which are developing eugenic ideologies and technologies to deal with what are social problems. Instead of empowering and valuing sex variations, the solution is to eliminate us.
Open discussions about the abuse of power by those who control the definitions is one important way to confront the real problem - eugenics, Euro-centric racism and male patriarchal models of power which are at risk of collapse if the current binary male/female dichotomies are not firmly held as sacrosanct.
We in OII do not accept the current male/female binary categories imposed on all people in most countries as sacrosanct and hope that others will help us confront the political agenda of those who would eliminate us.
Footnotes:
Footnotes:
(1) "Biological Essentialism: Biological essentialism refers to the idea that men and women are intrinsically different due to some internal essence. Biological essentialists argue that men and women are distinct from one another and that they are opposites. They claim that gender differences aren’t really differences in gender but that they reflect a biologically based difference that is consistent across cultures. Furthermore, biological essentialists stipulate that there is no variation in the expression of biologically essential characteristics."
http://www.geocities.com/CollegePark/Bookstore/2603/NEW261Y_Definitions.html
(2) Project 1-0-1 intersex
http://www.101intersex.de/index.php?=SID&sprache=En
(3) RACISM and SEXISM: A COLLECTIVE STRUGGLE: A MINORITY WOMAN'S POINT OF VIEW By Valerie Russell
http://scriptorium.lib.duke.edu/wlm/racesex/
(4) Brief history of eugenics: http://en.wikipedia.org/wiki/Eugenics#History
(5) What Is Gendercide? http://www.gendercide.org/
(6) Alice Dreger and some other women who have great privilege within the two-sex system have played a prominent role in pathologizing sex variations. For more information: click here
(2) Project 1-0-1 intersex
http://www.101intersex.de/index.php?=SID&sprache=En
(3) RACISM and SEXISM: A COLLECTIVE STRUGGLE: A MINORITY WOMAN'S POINT OF VIEW By Valerie Russell
http://scriptorium.lib.duke.edu/wlm/racesex/
(4) Brief history of eugenics: http://en.wikipedia.org/wiki/Eugenics#History
(5) What Is Gendercide? http://www.gendercide.org/
(6) Alice Dreger and some other women who have great privilege within the two-sex system have played a prominent role in pathologizing sex variations. For more information: click here
Monday, September 10, 2007
DSD - Is there really a consensus?
by Curtis E. Hinkle
We in OII have been interested in the new term which those who feel they speak for us are now imposing on us. Just as our sex was imposed on us without our consent, now the experts and DSD activists are imposing pejorative terminology on us as our new identity. Was there really any consultation of those directly affected by this new pejorative identity label? It appears there was not. Most of us do not identify as disordered nor do we feel that our sex is disordered.
On the following site, those interested were invited to respond to an article on Disorders of Sex Development. You will notice that there are almost no intersex adults in favor of this. The main proponents are doctors and in one case, a woman who is both a parent and a doctor (Arlene B. Baratz, MD).
Scroll down to read letters from intersex activists about DSD on the following site:
http://adc.bmjjournals.com/cgi/eletters/91/7/554
The Organisation Intersex International did a survey:
http://www.intersexualite.org/English_OII/IAIA/IAIA_index.html
DSD Survey results thus far:
http://www.intersexualite.org/English_OII/dsd_survey/dsd_survey.html
We in OII have been interested in the new term which those who feel they speak for us are now imposing on us. Just as our sex was imposed on us without our consent, now the experts and DSD activists are imposing pejorative terminology on us as our new identity. Was there really any consultation of those directly affected by this new pejorative identity label? It appears there was not. Most of us do not identify as disordered nor do we feel that our sex is disordered.
On the following site, those interested were invited to respond to an article on Disorders of Sex Development. You will notice that there are almost no intersex adults in favor of this. The main proponents are doctors and in one case, a woman who is both a parent and a doctor (Arlene B. Baratz, MD).
Scroll down to read letters from intersex activists about DSD on the following site:
http://adc.bmjjournals.com/cgi/eletters/91/7/554
The Organisation Intersex International did a survey:
http://www.intersexualite.org/English_OII/IAIA/IAIA_index.html
DSD Survey results thus far:
http://www.intersexualite.org/English_OII/dsd_survey/dsd_survey.html
Saturday, September 1, 2007
Eric Vilain, J Michael Bailey and DSD
by Curtis E. Hinkle
Founder, OII
(Note: I am personally biased against DSD terminology and the quest for finding a true sex for an individual, whether that be based on "brain sex" or any other genetic or biological marker. If I want to know the "true" sex of an individual, I simply let them tell me.)
I read an article this morning entitled:
Going beyond X and Y (c) 1996-2007 Scientific American, Inc. All rights reserved.
In this article Dr. Eric Vilain states that the term "intersex" is hurtful. OII did a survey which indicated that just the opposite is true among intersex adults. The overwhelming majority of those directly affected by this terminology and the subsequent protocols derived from it felt that "DSD" was hurtful. Three of the very few intersex participants in the DSD guidelines requested to have their objections to the terminology formally recognized within the publications.
Some background:
Dr. Eric Vilain is a member of the NICHD Network on Psychosexual Differentiation. The NICHD is a United States Federal Agency. The acronym stands for: National Institute of Child Health and Human Development. "The NICHD was initially established to investigate the broad aspects of human development as a means of understanding developmental disabilities, including mental retardation, and the events that occur during pregnancy. Today, the Institute conducts and supports research on all stages of human development, from preconception to adulthood, to better understand the health of children, adults, families, and communities." [1] "Since the NICHD was founded, one of its main focuses has been on understanding the causes of birth defects, and on their treatments and prevention." [2]
-------------------------------------------------------------------------------------------------------------
What concerns me with Dr. Vilain is that with his intense interest in brain sex and in discovering the causes of homosexuality, he seems to have no qualms in being closely associated with J Michael Bailey who is a colleague of his in the NICHD Network on Psychosexual Differentiation and also one of the members of that group who started introducing the use of DSD. Vilain is not interested in just the sex of an individual but the development throughout the life of an individual which involves gender identity and sexual orientation as well. I am not qualified to judge Dr. Vilain's science but I do feel obligated to express my opinions on the possible uses of that research. I have great problems with associating "birth defect" research with someone who has written a legal argument for aborting homosexual fetuses and this person is involved in the research with Dr. Vilain, namely: J Michael Bailey, who has written the following:
Parental Selection of Children’s Sexual Orientation
There are serious implications with J Michael Bailey being part of this network. He is also working closely with Berenbaum on the Tomboy project which is studying girls who are tomboys. Having the man who wrote The Man Who Would Be Queen involved with intersex researchers like Berenbaum to study tomboys is not an encouraging step forward in my opinion. J Michael Bailey is very interested in intersex research and I am very concerned that scientists of the caliber of Vilain would be associated at all with someone who has the academic track record of Bailey and who is one of the main members of the network and one of the original presenters at their early meetings. It is clear from the aims of the network what the focus is on:
“Develop or refine animal paradigms that model and help to explain the genetic, neuroendocrine, and social processes underlying both normal sex-typed behaviors and pathological behaviors observed in individuals with intersex conditions or gender-atypical behavior.”
http://nichdnet.psych.psu.edu/aims.html
Many people who visit our site most likely do not fit into what the NICHD would define as individuals with “normal sex-typed behaviors”. So beware. As intersex people are used to determine "normal sex-typed behaviors" and their origins, more and more of the population will be affected by the findings of this research which is being conducted by Vilain, Bailey and others. I would suggest that the science behind this cannot be separated from the surrounding sexist culture which finances it. Substitute the word "race" for the words "sex", "sexual" and "gender" as used in this research and it will be apparent just how sexist this research is and that the basic political and social assumptions which make these issues "important" to the scientific community are rooted in the political need to justify social norms for men and woman based on genetic findings.
The following article deals with Bailey’s research on Tomboys along with intersex researcher Sheri A. Berenbaum
Who Are Tomboys and Why Should We Study Them?
Journal Archives of Sexual Behavior
J. Michael Bailey, Kathleen T. Bechtold and Sheri A. Berenbaum
Issue Volume 31, Number 4 / August, 2002, Pages 333-341
It is also interesting that Anne Lawrence is on the APA Task Force on Gender Identity, Gender Variance, and Intersex Conditions. Everywhere I look, I see Bailey or close associates of his involved with intersex. I have no idea why Anne Lawrence would be on the APA committee for intersex. She has no connection whatsoever with the intersex community that I have ever heard of, nor does she have any scientific training in the field. Many intersexed people have told me that having anyone like Anne Lawrence associated even remotely with intersex issues is not only disturbing but extremely offensive because she has elaborated a theory for explaining a sexual fetish for feminizing surgeries that she has which she uses to explain her particular experience and her desire for feminizing surgery and many intersexed people feel that their own feminizing surgeries in childhood could be sexualized and misunderstood by people such as Anne Lawrence studying their gender variance. No one we are aware of in the intersex community is questioning her sexual desire for feminizing surgery as a reason for her sex change. We just don't feel it has any place in the discussion of intersex people who are gender variant. Also, many intersex adults are disturbed that intersex activist Alice Dreger would recommend such a person as a speaker or that Alice Dreger would defend such a position since most of us thought that Dreger was more interested in intersex than ideological battles within the trans community. However, we have found this not to be the case. Dreger has made it clear that she has taken a very specific side in this debate: pro-Bailey and therefore pro-Lawrence. (See footnote)
I would like to point out a dangerous trend in the intersex community that has been evident to many of us over the years and that is some intersex activists insist on marginalizing those who do not agree with them as genderqueer or third gender and therefore not representative of the community or they simply label them transgender. OII has been repeatedly referred to as a transgender organization despite the fact that most of the board members have never rejected their assigned sex. Also, it comes across to many of us that the way some intersex activists have made these allegations that they think that transgender is something bad. OII-Spokeswoman for the United Kingdom stated:
"The problem I have at present is the confusion around how people who rejected their original assignment are defined. On the one hand we are defined as "Transgendered" but this somehow implies that the original assignation was "Correct" and objecting to it was "Going against what someone is supposed to be". When someone calls me "Transgendered", I usually take it to mean that they justify the surgery I was subjected to as a child.
This is in my view where people like Bailey and Lawrence seem to appear, and to some extent Alice Dreger. It sort of feels like if you do object to the original assignation, for whatever reason (It is not always issues of gender identity or sexuality either; it is more complex than that. In my case it was in part a reaction to being brutalized as a part of the "socialization" and in part a reaction against the surgery itself.), you are sort of "handed over" to the Bailey/Lawrence department of being mocked and lied to basically, in the same way both of them indeed mock transsexuals."
Unfortunately many influential people in the intersex community are closely associated with J Michael Bailey and the transphobia that infected many intersex groups may very well be the reason. For more documentation on DSD and connections with Bailey:
http://www.intersexualite.org/AliceDreger.html
In conclusion, OII was not well-informed about the Bailey controversy in the trans community until it became apparent that he was so close to a lot of the research on intersex. As a result, OII feels obligated to make it clear that we do not want to be associated with Bailey or seen as endorsing any of his ideas or theories. As far as recommending people in the trans community as speakers or other representatives, we see no need to do this. It appears to us that the trans community at large has been able to make their views clear and need no help from us. Our objections to Bailey are based on his own record of poor scholarship, use of intersex to find causes of gender identity and sexual orientation and his extreme binary male/female identity politics which exclude us totally from the debate.
Footnote:
The following is from Alice Dreger's blog:
P.S. Several readers have asked me who I would recommend if they were interested in inviting a transgender activist/advocate to their campus to speak. Lots of great folks spring to mind, but let me here recommend four: (3) clinician and scholar Anne Lawrence, M.D., Ph.D. whose work has focused on improving healthcare for transgender women like herself;
The following is an e-mail that Alice Dreger circulated on the internet to certain intersex activists in which she alleges that the writer of this article, Curtis E. Hinkle, is working with Andrea James to destroy the intersex community. Not only am I not guilty by association, I am not associated with Andrea James. Such smear tactics have a long history in Alice Dreger's approach to intersex activism and her silencing of a large segment of the intersex community who do not agree with her views on gender.
Letters from intersex activists around the world who have been silenced and marginalized by Alice Dreger.
Founder, OII
(Note: I am personally biased against DSD terminology and the quest for finding a true sex for an individual, whether that be based on "brain sex" or any other genetic or biological marker. If I want to know the "true" sex of an individual, I simply let them tell me.)
I read an article this morning entitled:
Going beyond X and Y (c) 1996-2007 Scientific American, Inc. All rights reserved.
In this article Dr. Eric Vilain states that the term "intersex" is hurtful. OII did a survey which indicated that just the opposite is true among intersex adults. The overwhelming majority of those directly affected by this terminology and the subsequent protocols derived from it felt that "DSD" was hurtful. Three of the very few intersex participants in the DSD guidelines requested to have their objections to the terminology formally recognized within the publications.
Some background:
Dr. Eric Vilain is a member of the NICHD Network on Psychosexual Differentiation. The NICHD is a United States Federal Agency. The acronym stands for: National Institute of Child Health and Human Development. "The NICHD was initially established to investigate the broad aspects of human development as a means of understanding developmental disabilities, including mental retardation, and the events that occur during pregnancy. Today, the Institute conducts and supports research on all stages of human development, from preconception to adulthood, to better understand the health of children, adults, families, and communities." [1] "Since the NICHD was founded, one of its main focuses has been on understanding the causes of birth defects, and on their treatments and prevention." [2]
-------------------------------------------------------------------------------------------------------------
What concerns me with Dr. Vilain is that with his intense interest in brain sex and in discovering the causes of homosexuality, he seems to have no qualms in being closely associated with J Michael Bailey who is a colleague of his in the NICHD Network on Psychosexual Differentiation and also one of the members of that group who started introducing the use of DSD. Vilain is not interested in just the sex of an individual but the development throughout the life of an individual which involves gender identity and sexual orientation as well. I am not qualified to judge Dr. Vilain's science but I do feel obligated to express my opinions on the possible uses of that research. I have great problems with associating "birth defect" research with someone who has written a legal argument for aborting homosexual fetuses and this person is involved in the research with Dr. Vilain, namely: J Michael Bailey, who has written the following:
Parental Selection of Children’s Sexual Orientation
There are serious implications with J Michael Bailey being part of this network. He is also working closely with Berenbaum on the Tomboy project which is studying girls who are tomboys. Having the man who wrote The Man Who Would Be Queen involved with intersex researchers like Berenbaum to study tomboys is not an encouraging step forward in my opinion. J Michael Bailey is very interested in intersex research and I am very concerned that scientists of the caliber of Vilain would be associated at all with someone who has the academic track record of Bailey and who is one of the main members of the network and one of the original presenters at their early meetings. It is clear from the aims of the network what the focus is on:
“Develop or refine animal paradigms that model and help to explain the genetic, neuroendocrine, and social processes underlying both normal sex-typed behaviors and pathological behaviors observed in individuals with intersex conditions or gender-atypical behavior.”
http://nichdnet.psych.psu.edu/aims.html
Many people who visit our site most likely do not fit into what the NICHD would define as individuals with “normal sex-typed behaviors”. So beware. As intersex people are used to determine "normal sex-typed behaviors" and their origins, more and more of the population will be affected by the findings of this research which is being conducted by Vilain, Bailey and others. I would suggest that the science behind this cannot be separated from the surrounding sexist culture which finances it. Substitute the word "race" for the words "sex", "sexual" and "gender" as used in this research and it will be apparent just how sexist this research is and that the basic political and social assumptions which make these issues "important" to the scientific community are rooted in the political need to justify social norms for men and woman based on genetic findings.
The following article deals with Bailey’s research on Tomboys along with intersex researcher Sheri A. Berenbaum
Who Are Tomboys and Why Should We Study Them?
Journal Archives of Sexual Behavior
J. Michael Bailey, Kathleen T. Bechtold and Sheri A. Berenbaum
Issue Volume 31, Number 4 / August, 2002, Pages 333-341
It is also interesting that Anne Lawrence is on the APA Task Force on Gender Identity, Gender Variance, and Intersex Conditions. Everywhere I look, I see Bailey or close associates of his involved with intersex. I have no idea why Anne Lawrence would be on the APA committee for intersex. She has no connection whatsoever with the intersex community that I have ever heard of, nor does she have any scientific training in the field. Many intersexed people have told me that having anyone like Anne Lawrence associated even remotely with intersex issues is not only disturbing but extremely offensive because she has elaborated a theory for explaining a sexual fetish for feminizing surgeries that she has which she uses to explain her particular experience and her desire for feminizing surgery and many intersexed people feel that their own feminizing surgeries in childhood could be sexualized and misunderstood by people such as Anne Lawrence studying their gender variance. No one we are aware of in the intersex community is questioning her sexual desire for feminizing surgery as a reason for her sex change. We just don't feel it has any place in the discussion of intersex people who are gender variant. Also, many intersex adults are disturbed that intersex activist Alice Dreger would recommend such a person as a speaker or that Alice Dreger would defend such a position since most of us thought that Dreger was more interested in intersex than ideological battles within the trans community. However, we have found this not to be the case. Dreger has made it clear that she has taken a very specific side in this debate: pro-Bailey and therefore pro-Lawrence. (See footnote)
I would like to point out a dangerous trend in the intersex community that has been evident to many of us over the years and that is some intersex activists insist on marginalizing those who do not agree with them as genderqueer or third gender and therefore not representative of the community or they simply label them transgender. OII has been repeatedly referred to as a transgender organization despite the fact that most of the board members have never rejected their assigned sex. Also, it comes across to many of us that the way some intersex activists have made these allegations that they think that transgender is something bad. OII-Spokeswoman for the United Kingdom stated:
"The problem I have at present is the confusion around how people who rejected their original assignment are defined. On the one hand we are defined as "Transgendered" but this somehow implies that the original assignation was "Correct" and objecting to it was "Going against what someone is supposed to be". When someone calls me "Transgendered", I usually take it to mean that they justify the surgery I was subjected to as a child.
This is in my view where people like Bailey and Lawrence seem to appear, and to some extent Alice Dreger. It sort of feels like if you do object to the original assignation, for whatever reason (It is not always issues of gender identity or sexuality either; it is more complex than that. In my case it was in part a reaction to being brutalized as a part of the "socialization" and in part a reaction against the surgery itself.), you are sort of "handed over" to the Bailey/Lawrence department of being mocked and lied to basically, in the same way both of them indeed mock transsexuals."
Unfortunately many influential people in the intersex community are closely associated with J Michael Bailey and the transphobia that infected many intersex groups may very well be the reason. For more documentation on DSD and connections with Bailey:
http://www.intersexualite.org/AliceDreger.html
In conclusion, OII was not well-informed about the Bailey controversy in the trans community until it became apparent that he was so close to a lot of the research on intersex. As a result, OII feels obligated to make it clear that we do not want to be associated with Bailey or seen as endorsing any of his ideas or theories. As far as recommending people in the trans community as speakers or other representatives, we see no need to do this. It appears to us that the trans community at large has been able to make their views clear and need no help from us. Our objections to Bailey are based on his own record of poor scholarship, use of intersex to find causes of gender identity and sexual orientation and his extreme binary male/female identity politics which exclude us totally from the debate.
Footnote:
The following is from Alice Dreger's blog:
P.S. Several readers have asked me who I would recommend if they were interested in inviting a transgender activist/advocate to their campus to speak. Lots of great folks spring to mind, but let me here recommend four: (3) clinician and scholar Anne Lawrence, M.D., Ph.D. whose work has focused on improving healthcare for transgender women like herself;
The following is an e-mail that Alice Dreger circulated on the internet to certain intersex activists in which she alleges that the writer of this article, Curtis E. Hinkle, is working with Andrea James to destroy the intersex community. Not only am I not guilty by association, I am not associated with Andrea James. Such smear tactics have a long history in Alice Dreger's approach to intersex activism and her silencing of a large segment of the intersex community who do not agree with her views on gender.
Letters from intersex activists around the world who have been silenced and marginalized by Alice Dreger.
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