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.
Thursday, July 17, 2008
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]
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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.
Saturday, September 30, 2006
DSD Consortium: Homophobia and transphobia exposed
by Curtis E. Hinkle
Very oddly, the DSD Consortium handbook website lists no DSD Consortium address, contact information or member information, but simply posts links to the brochures published by ISNA, as you'll see at the following links:
http://www.dsdguidelines.org/
http://www.dsdguidelines.org/about/consortium
In particular, the Consortium website does not mention the actual "research" group behind this front, namely the "The Network on Psychosexual Differentiation", funded by the NICHD and based at Penn State and Northwestern University:
http://www.intersexualite.org/English_OII/IAIA/IAIA_index.html
http://nichdnet.psych.psu.edu/
Nor does it mention the pathologizing language in the "mission statement" of that group:
http://nichdnet.psych.psu.edu/aims.html
The DSD Consortium website also fails to mention that the principle author/editor of consortium information is Ms. Alice Dreger, a failed academic who recently resigned her position from Michigan State University under a cloud of acrimony (she has since written highly negative things about academic life). Dreger has recently been hired by Northwestern University into an administrative position as a spokesperson for NU's sex research, with the title of "Project Coordinator for publications of the Consortium on the Management of Disorders of Sex Development".
Among other things, Dreger is a defender of the notorious J. Michael Bailey, a disgraced faculty member who is a member of NU's sex research group. Mr. Bailey is well-known for advocating homosexual eugenics, and was a key participant in the early meetings that established the pathologizing terminology and mission of the DSD consortium, as you'll see in the attendee lists:
http://nichdnet.psych.psu.edu/meetings.html
Mr. Bailey's work has become notorious in the GBLT community for his defamations of GLBT people, and he has been denounced by almost all key advocacy groups, as in these examples:
http://www.glaad.org/action/write_now_detail.php?id=3827
http://www.thetaskforce.org/downloads/NYTBisexualityFactSheet.pdf
http://advocate.com/exclusive_detail_ektid29121.asp
http://www.splcenter.org/intel/intelreport/article.jsp?sid=96
Furthermore, gay media have recently refused to take ads for research subjects from projects that involve Bailey in their work:
"Since we cannot in good conscience steer our readers to a study that Bailey is part of, we’re canceling the ad. And in the future, before accepting any ads for research studies, our ad staff will ask who is involved. If Bailey is, we won’t accept the ads." - Editors of the Chicago Free Press
Could it be that Ms. Dreger wishes to minimize the exposure of the DSD Consortium's close ties with the pathologizing thinking of such infamous Northwestern University sex researchers?
-----------------
UPDATE Sept. 24, 2006: Ms. Dreger is planning to resign from the DSD Consortium. She has apparently cracked under the pressure of the exposure of the "DSD pathologizations" that she and Cheryl Chase and the NICHD crowd recently launched against intersex people. She now appears to be going into denial that she had anything to do with this mess, even though she was one of the principle authors of it all!
-----------------
Chicago Free Press
August 9, 2006
Editorial: Bad Science
Recently, CFP ran an ad for a research study seeking gay men with gay brothers. The study is based at Northwestern University and other institutions.
A few CFP readers looked into the study and found that one of the principal researchers is Northwestern psychology professor J. Michael Bailey.
Bailey is a controversial figure, to say the least. His 2003 book, “The Man Who Would Be Queen,” has been heavily criticized by transgender activists, who say it falsely characterizes transgenders as “especially motivated” to shoplift and asserts that “the single most common occupation” of transgenders is prostitution. The book was not footnoted, as serious research commonly is, and some Chicago transgenders said Bailey befriended them in bars and never told them he was using them as subjects for his book, which is clearly wrong.
Northwestern officials investigated the complaints, and while they would not comment on their findings, Bailey subsequently resigned as chairman of the school’s psychology department, although he remains on staff there. Bailey never responded to CFP questions about his book or his research. He has since created a “Book Controversy Question & Answer” section on his website, but it doesn’t address any of the allegations listed above.
The book is not the only controversial aspect to Bailey’s research. The Gay and Lesbian Alliance Against Defamation blasted Bailey and an article about his research in the New York Times in 2005. The subject of that article, a research paper co-written by Bailey and a graduate student, asserted, “It remains to be shown that male bisexuality exists.” Bailey based that claim on experiments involving a widely discredited scientific instrument developed in Stalinist Czechoslovakia in the 1950s to measure soldiers’ responses to sexual stimuli.
Media watchdog group Fairness and Accuracy in Reporting said in a statement about the Times article, “In suggesting that men who claim a bisexual sexual orientation are liars, the Times relies heavily on a single study whose senior researcher has a career marked by ethics controversies and eugenics proposals.”
Bailey has also generalized that gay men tend to be feminine boys, and part of his current study is aimed at pursuing that theory. He has generalized that most gay men are ashamed of being perceived as feminine, an assertion that demonstrates how Bailey lets his own feelings and assumptions about what’s masculine or feminine, even gay or straight, guide his findings.
The current study is also aimed at finding a genetic basis for homosexuality. If that were discovered, and parents were consequently able to ensure that their offspring were not gay (something that many scientists believe isn’t possible), Bailey has said that such a choice “would be morally unproblematic.”
“It is quite hard to see how being heterosexual causes any harm to the child,” Bailey said at a 2004 forum at Northwestern.
Thanks to the heads-up from our readers, we looked into Bailey’s involvement in this study and found it to be substantial. Since we cannot in good conscience steer our readers to a study that Bailey is part of, we’re canceling the ad. And in the future, before accepting any ads for research studies, our ad staff will ask who is involved. If Bailey is, we won’t accept the ads.
There are other researchers involved in this study. They may have good motives, but we question their association with Bailey. We appreciate good science. We don’t appreciate being used to further the dubious agenda of someone who believes he should not be held accountable to our community.
Very oddly, the DSD Consortium handbook website lists no DSD Consortium address, contact information or member information, but simply posts links to the brochures published by ISNA, as you'll see at the following links:
http://www.dsdguidelines.org/
http://www.dsdguidelines.org/about/consortium
In particular, the Consortium website does not mention the actual "research" group behind this front, namely the "The Network on Psychosexual Differentiation", funded by the NICHD and based at Penn State and Northwestern University:
http://www.intersexualite.org/English_OII/IAIA/IAIA_index.html
http://nichdnet.psych.psu.edu/
Nor does it mention the pathologizing language in the "mission statement" of that group:
http://nichdnet.psych.psu.edu/aims.html
The DSD Consortium website also fails to mention that the principle author/editor of consortium information is Ms. Alice Dreger, a failed academic who recently resigned her position from Michigan State University under a cloud of acrimony (she has since written highly negative things about academic life). Dreger has recently been hired by Northwestern University into an administrative position as a spokesperson for NU's sex research, with the title of "Project Coordinator for publications of the Consortium on the Management of Disorders of Sex Development".
Among other things, Dreger is a defender of the notorious J. Michael Bailey, a disgraced faculty member who is a member of NU's sex research group. Mr. Bailey is well-known for advocating homosexual eugenics, and was a key participant in the early meetings that established the pathologizing terminology and mission of the DSD consortium, as you'll see in the attendee lists:
http://nichdnet.psych.psu.edu/meetings.html
Mr. Bailey's work has become notorious in the GBLT community for his defamations of GLBT people, and he has been denounced by almost all key advocacy groups, as in these examples:
http://www.glaad.org/action/write_now_detail.php?id=3827
http://www.thetaskforce.org/downloads/NYTBisexualityFactSheet.pdf
http://advocate.com/exclusive_detail_ektid29121.asp
http://www.splcenter.org/intel/intelreport/article.jsp?sid=96
Furthermore, gay media have recently refused to take ads for research subjects from projects that involve Bailey in their work:
"Since we cannot in good conscience steer our readers to a study that Bailey is part of, we’re canceling the ad. And in the future, before accepting any ads for research studies, our ad staff will ask who is involved. If Bailey is, we won’t accept the ads." - Editors of the Chicago Free Press
Could it be that Ms. Dreger wishes to minimize the exposure of the DSD Consortium's close ties with the pathologizing thinking of such infamous Northwestern University sex researchers?
-----------------
UPDATE Sept. 24, 2006: Ms. Dreger is planning to resign from the DSD Consortium. She has apparently cracked under the pressure of the exposure of the "DSD pathologizations" that she and Cheryl Chase and the NICHD crowd recently launched against intersex people. She now appears to be going into denial that she had anything to do with this mess, even though she was one of the principle authors of it all!
-----------------
Chicago Free Press
August 9, 2006
Editorial: Bad Science
Recently, CFP ran an ad for a research study seeking gay men with gay brothers. The study is based at Northwestern University and other institutions.
A few CFP readers looked into the study and found that one of the principal researchers is Northwestern psychology professor J. Michael Bailey.
Bailey is a controversial figure, to say the least. His 2003 book, “The Man Who Would Be Queen,” has been heavily criticized by transgender activists, who say it falsely characterizes transgenders as “especially motivated” to shoplift and asserts that “the single most common occupation” of transgenders is prostitution. The book was not footnoted, as serious research commonly is, and some Chicago transgenders said Bailey befriended them in bars and never told them he was using them as subjects for his book, which is clearly wrong.
Northwestern officials investigated the complaints, and while they would not comment on their findings, Bailey subsequently resigned as chairman of the school’s psychology department, although he remains on staff there. Bailey never responded to CFP questions about his book or his research. He has since created a “Book Controversy Question & Answer” section on his website, but it doesn’t address any of the allegations listed above.
The book is not the only controversial aspect to Bailey’s research. The Gay and Lesbian Alliance Against Defamation blasted Bailey and an article about his research in the New York Times in 2005. The subject of that article, a research paper co-written by Bailey and a graduate student, asserted, “It remains to be shown that male bisexuality exists.” Bailey based that claim on experiments involving a widely discredited scientific instrument developed in Stalinist Czechoslovakia in the 1950s to measure soldiers’ responses to sexual stimuli.
Media watchdog group Fairness and Accuracy in Reporting said in a statement about the Times article, “In suggesting that men who claim a bisexual sexual orientation are liars, the Times relies heavily on a single study whose senior researcher has a career marked by ethics controversies and eugenics proposals.”
Bailey has also generalized that gay men tend to be feminine boys, and part of his current study is aimed at pursuing that theory. He has generalized that most gay men are ashamed of being perceived as feminine, an assertion that demonstrates how Bailey lets his own feelings and assumptions about what’s masculine or feminine, even gay or straight, guide his findings.
The current study is also aimed at finding a genetic basis for homosexuality. If that were discovered, and parents were consequently able to ensure that their offspring were not gay (something that many scientists believe isn’t possible), Bailey has said that such a choice “would be morally unproblematic.”
“It is quite hard to see how being heterosexual causes any harm to the child,” Bailey said at a 2004 forum at Northwestern.
Thanks to the heads-up from our readers, we looked into Bailey’s involvement in this study and found it to be substantial. Since we cannot in good conscience steer our readers to a study that Bailey is part of, we’re canceling the ad. And in the future, before accepting any ads for research studies, our ad staff will ask who is involved. If Bailey is, we won’t accept the ads.
There are other researchers involved in this study. They may have good motives, but we question their association with Bailey. We appreciate good science. We don’t appreciate being used to further the dubious agenda of someone who believes he should not be held accountable to our community.
Monday, September 18, 2006
Pathological (hetero)sexism and the medicalisation of sex in children
Intersex – The sex that dare not speak its name
by Curtis E. Hinkle
It is hardly a newsflash that we live in a sexist society. However, just when we think we might be making progress in our struggle for equality and dignity, we are sometimes surprised at the backlash and the political power behind it. We have seen evidence of this powerful (hetero)sexist machinery in the United States just recently with the announcement by ISNA, the Intersex Society of North American, concerning its embrace of the term “disorder of sex development”. This term is supposedly better for children than the term “intersex”, according to this US group.
I read an article just the other day by Vincent Guillot, an intersex activist in Europe, entitled “C’est à nous de sortir du discours medical” (“It is up to us to distance ourselves from medical discourse”). I agree. It is also up to those of us who are intersex adults to speak out against pathological (hetero)sexism and its devastating effects on intersex children. We were once children. The doctors and experts who speak for us often do not have our best interest at heart. They are part of the sexist machinery which has so damaged many of us as children, who have not listened to us and who continue to control our lives.
The fact that many intersex adults may in fact feel that they suffer from a medical condition in no way should silence those of us who disagree with this view of our sex. The term intersex was quite capable of being used as both a medical term referring to a condition of atypical sex differentiation and those wishing medical help were able to get help with all the current pathological diagnoses which are associated with those of us who have bodies which are not standard male or female. No one was dictating to the intersex adults who viewed their bodies from a pathological perspective about how to seek help, nor was anyone saying they did not have a right to view their intersex condition as a pathology. The situation has changed drastically however with the term DSD or “disorder of sex development”. This disenfranchises a large segment of the intersex community because it is purely pathological, sexist and humiliating to many of us. We also have a right to protect children from such damaging, sexist, pathological politics which are entrenched in our medical, legal and social institutions.
Let’s look closely at this term. It may help us understand the mentality of those who would choose to use this in speaking about a defenceless child. First of all, they are saying the child is disordered. Merck is the publisher of one of the most popular medical reference books in the United States. This is the definition of “disorder” from their website: “a derangement or abnormality of function; a morbid physical or mental state.” (1) From the day of birth and often even before birth, the intersexed child is now going to be labelled as deranged or abnormal because there is a perceived malfunction or morbid physical state. This deranged or abnormal malfunction is based on centuries of defining people by sexual reporductive function. To define a child based on their future sexual and reproductive function is clearly sexist and something most children would not understand since most have no concept what it means to be sexually functioning adults. It sexualizes infants and sends the message that their real purpose in life is to have biological parts which would work heterosexually for reproductive purposes even if no treatment devised will probably permit many of them to reproduce. The proposed treatments often simply allow the intersexed infant to simulate heterosexual activity later in life, something the child may have no interest in as they mature and come to terms with their sexuality or lack of sexual interest. It is incorrect to assume that all children will want to simulate heterosexual copulation as adults. This often makes them even more ashamed because they are being treated for a deranged state (that of not being born with what is deemed proper for future reproductive, and therefore heterosexual, functioning). Their body becomes a destabilizing element to such sexist, political institutions and the young child is propelled into an array of sexist discourse about who they are and what their body should look like in order to have any hope of fitting into the system. But what I would like to ask is this: Is this really helping the child? Is the child really deranged or abnormal? Does this really require medical intervention? What is really sick about the body of the intersexed child? Why does the child need to be ordered? I think that the answer to everyone of these questions is based on profoundly sexist and heterosexist political discourse which controls our societies and has little to do with the interest of the child. It is all about the health of the heterosexist political institutions in our societies. The disorder or derangement is not in the body of the child in my opinion; it is in the society which the child is going to have to live in which is going to use a whole panoply of biomedical technology to enforce an unnatural order which has been accepted as self-evident and therefore requiring all possible measures to impose this unnatural order on all bodies which do not conform to the sexist division of all people into female and male. To blur the arbitrary division between these two categories of people is threatening to (hetero)sexist dictatorships which thrive on male/female dichotomies and the resulting power they receive within the system. The inequality of power among members within this system is not viewed as the real threat. No, it is the body of a defenceless child which is the battleground and s/he will pay a big price for having a body which questions the arbitrary, sexist categories required to make the heterosexist system work.
Sex is the next word in the new term “DSD” used to replace intersex, the sex that dare not speak its name. The following is a rather good definition of what most people are talking about when they use this word:\
"A biological construct premised upon biological characteristics enabling sexual reproduction" (from Krieger N. A Glossary for Social Epidemiology, J Epidemiol Community Health 2001; 55:693-700.)
We see the inherent heterosexism in this definition. From a biological perspective, sex in humans is basically dimorphic. But even from a biological perspective, sex cannot be defined as dimorphic. However, biology is just one area of science dealing with the human body and sex. From a genetic perspective, sex in humans becomes much more complex and less dimorphic. Genetic variations within individuals which would make them not standard male or female are numerous, with very few people being totally male or totally female. Even using the terms “male” and “female” when referring to genetic markers poses serious problems because what one is calling a “male” marker does not inevitably lead to “maleness”, etc. The sexism of the arbitrary, binary construct becomes even more obvious when trying to talk about genetic components of sex.
The message that many intersexed children will hear is that their sex itself is a disorder, a disability and a deranged physical state. This does nothing to relieve the shame and stigma associated with being intersex. I feel it only increases the shame and stigma because we are once again making intersex the sex that dare not speak its name. Just as being a hermaphrodite was so humiliating, the more accurate term “intersex” now is deemed too “political” to use when speaking about an infant. (See article by ISNA about why they feel intersex is too political.) (2) What is really wrong with not being clearly male or female? Can we not love a child that does not meet these unnatural norms? Red hair is not typical but it is natural for infants to be born with red hair and it is just as natural for children to be born intersex and it usually requires no more medical treatment than being born with red hair. Both children, the one with red hair and the intersexed child need love and acceptance from parents. Denying who you are and pretending you are not intersexed is not a loving, nurturing act in my opinion. It further damages the child.
We have two officially legal sexes. This legal system is necessary for a heterosexist patriarchy. However, it is not natural. It is politically and socially imposed and the intersexed child risks paying an extremely high price for revealing the obvious – there are not just two sexes. The child was unfortunate enough to be born of a sex that dare not speak its name – intersex.
Next, we have the word “development” as part of the new medical diagnosis for the young child. I have personally felt that the word "differentiation" is more accurate because what the medical experts are viewing as disordered is that the foetus did not differentiate “properly” into a male or a female. The word “differentiate” seems more accurate because we are actually talking about maintaining strict “differences” between male and female. Choosing the word “development” appears obfuscating to me – as if the DSD activists are trying to say that the problem is just that certain reproductive parts did not develop properly when the problem really is that the child is defying the strict and very arbitrary divisions between what we classify as male or female. This is clear if we were to consider how a child born with a big penis is treated. Most likely the child would not be viewed as having a disorder of sex development, even though the genitalia would be “overdeveloped” in relation to most other infants born. No, having a big penis would not blur the sexist legal categories of male and female. There would be no treatments for this child most likely. The problem is not clearly being differentiated as male or female and has nothing to do with development, underdevelopment or overdevelopment.
I read an interesting commentary by a very articulate intersex activist who mentioned the connotations of the word “development” and his reasoning made a lot of sense to me. By using this term, the child is being told they might be undeveloped. This is certainly not a very enabling way of talking about children.
What it seems to boil down to in my opinion is that those of us who did not develop into the full malehood are now simply underdeveloped people and children. This keeps the category “male” even safer and harder to attain, even though many of us identify as male or live as male.
I think that those of us in the intersex community who disagree with this sexist politicization of intersex infants and their bodies have a right to speak out. Others have the right to speak for children also, not just a select few.
In my opinion, being deranged, deformed, of the wrong sex, and undeveloped does not help infants and children. Dare to speak up for them. Dare to speak the sex that dare not speak its name – INTERSEX.
Footnotes:
(1) Mercks definition of disorder is found at
http://tinyurl.com/7flku
(2) "Parents and doctors are not going to want to give a child a label with a politicized meaning." From ISNA's article on why they are using the term DSD (Disorder of Sex Developtment) found at
http://www.isna.org/node/1066
by Curtis E. Hinkle
It is hardly a newsflash that we live in a sexist society. However, just when we think we might be making progress in our struggle for equality and dignity, we are sometimes surprised at the backlash and the political power behind it. We have seen evidence of this powerful (hetero)sexist machinery in the United States just recently with the announcement by ISNA, the Intersex Society of North American, concerning its embrace of the term “disorder of sex development”. This term is supposedly better for children than the term “intersex”, according to this US group.
I read an article just the other day by Vincent Guillot, an intersex activist in Europe, entitled “C’est à nous de sortir du discours medical” (“It is up to us to distance ourselves from medical discourse”). I agree. It is also up to those of us who are intersex adults to speak out against pathological (hetero)sexism and its devastating effects on intersex children. We were once children. The doctors and experts who speak for us often do not have our best interest at heart. They are part of the sexist machinery which has so damaged many of us as children, who have not listened to us and who continue to control our lives.
The fact that many intersex adults may in fact feel that they suffer from a medical condition in no way should silence those of us who disagree with this view of our sex. The term intersex was quite capable of being used as both a medical term referring to a condition of atypical sex differentiation and those wishing medical help were able to get help with all the current pathological diagnoses which are associated with those of us who have bodies which are not standard male or female. No one was dictating to the intersex adults who viewed their bodies from a pathological perspective about how to seek help, nor was anyone saying they did not have a right to view their intersex condition as a pathology. The situation has changed drastically however with the term DSD or “disorder of sex development”. This disenfranchises a large segment of the intersex community because it is purely pathological, sexist and humiliating to many of us. We also have a right to protect children from such damaging, sexist, pathological politics which are entrenched in our medical, legal and social institutions.
Let’s look closely at this term. It may help us understand the mentality of those who would choose to use this in speaking about a defenceless child. First of all, they are saying the child is disordered. Merck is the publisher of one of the most popular medical reference books in the United States. This is the definition of “disorder” from their website: “a derangement or abnormality of function; a morbid physical or mental state.” (1) From the day of birth and often even before birth, the intersexed child is now going to be labelled as deranged or abnormal because there is a perceived malfunction or morbid physical state. This deranged or abnormal malfunction is based on centuries of defining people by sexual reporductive function. To define a child based on their future sexual and reproductive function is clearly sexist and something most children would not understand since most have no concept what it means to be sexually functioning adults. It sexualizes infants and sends the message that their real purpose in life is to have biological parts which would work heterosexually for reproductive purposes even if no treatment devised will probably permit many of them to reproduce. The proposed treatments often simply allow the intersexed infant to simulate heterosexual activity later in life, something the child may have no interest in as they mature and come to terms with their sexuality or lack of sexual interest. It is incorrect to assume that all children will want to simulate heterosexual copulation as adults. This often makes them even more ashamed because they are being treated for a deranged state (that of not being born with what is deemed proper for future reproductive, and therefore heterosexual, functioning). Their body becomes a destabilizing element to such sexist, political institutions and the young child is propelled into an array of sexist discourse about who they are and what their body should look like in order to have any hope of fitting into the system. But what I would like to ask is this: Is this really helping the child? Is the child really deranged or abnormal? Does this really require medical intervention? What is really sick about the body of the intersexed child? Why does the child need to be ordered? I think that the answer to everyone of these questions is based on profoundly sexist and heterosexist political discourse which controls our societies and has little to do with the interest of the child. It is all about the health of the heterosexist political institutions in our societies. The disorder or derangement is not in the body of the child in my opinion; it is in the society which the child is going to have to live in which is going to use a whole panoply of biomedical technology to enforce an unnatural order which has been accepted as self-evident and therefore requiring all possible measures to impose this unnatural order on all bodies which do not conform to the sexist division of all people into female and male. To blur the arbitrary division between these two categories of people is threatening to (hetero)sexist dictatorships which thrive on male/female dichotomies and the resulting power they receive within the system. The inequality of power among members within this system is not viewed as the real threat. No, it is the body of a defenceless child which is the battleground and s/he will pay a big price for having a body which questions the arbitrary, sexist categories required to make the heterosexist system work.
Sex is the next word in the new term “DSD” used to replace intersex, the sex that dare not speak its name. The following is a rather good definition of what most people are talking about when they use this word:\
"A biological construct premised upon biological characteristics enabling sexual reproduction" (from Krieger N. A Glossary for Social Epidemiology, J Epidemiol Community Health 2001; 55:693-700.)
We see the inherent heterosexism in this definition. From a biological perspective, sex in humans is basically dimorphic. But even from a biological perspective, sex cannot be defined as dimorphic. However, biology is just one area of science dealing with the human body and sex. From a genetic perspective, sex in humans becomes much more complex and less dimorphic. Genetic variations within individuals which would make them not standard male or female are numerous, with very few people being totally male or totally female. Even using the terms “male” and “female” when referring to genetic markers poses serious problems because what one is calling a “male” marker does not inevitably lead to “maleness”, etc. The sexism of the arbitrary, binary construct becomes even more obvious when trying to talk about genetic components of sex.
The message that many intersexed children will hear is that their sex itself is a disorder, a disability and a deranged physical state. This does nothing to relieve the shame and stigma associated with being intersex. I feel it only increases the shame and stigma because we are once again making intersex the sex that dare not speak its name. Just as being a hermaphrodite was so humiliating, the more accurate term “intersex” now is deemed too “political” to use when speaking about an infant. (See article by ISNA about why they feel intersex is too political.) (2) What is really wrong with not being clearly male or female? Can we not love a child that does not meet these unnatural norms? Red hair is not typical but it is natural for infants to be born with red hair and it is just as natural for children to be born intersex and it usually requires no more medical treatment than being born with red hair. Both children, the one with red hair and the intersexed child need love and acceptance from parents. Denying who you are and pretending you are not intersexed is not a loving, nurturing act in my opinion. It further damages the child.
We have two officially legal sexes. This legal system is necessary for a heterosexist patriarchy. However, it is not natural. It is politically and socially imposed and the intersexed child risks paying an extremely high price for revealing the obvious – there are not just two sexes. The child was unfortunate enough to be born of a sex that dare not speak its name – intersex.
Next, we have the word “development” as part of the new medical diagnosis for the young child. I have personally felt that the word "differentiation" is more accurate because what the medical experts are viewing as disordered is that the foetus did not differentiate “properly” into a male or a female. The word “differentiate” seems more accurate because we are actually talking about maintaining strict “differences” between male and female. Choosing the word “development” appears obfuscating to me – as if the DSD activists are trying to say that the problem is just that certain reproductive parts did not develop properly when the problem really is that the child is defying the strict and very arbitrary divisions between what we classify as male or female. This is clear if we were to consider how a child born with a big penis is treated. Most likely the child would not be viewed as having a disorder of sex development, even though the genitalia would be “overdeveloped” in relation to most other infants born. No, having a big penis would not blur the sexist legal categories of male and female. There would be no treatments for this child most likely. The problem is not clearly being differentiated as male or female and has nothing to do with development, underdevelopment or overdevelopment.
I read an interesting commentary by a very articulate intersex activist who mentioned the connotations of the word “development” and his reasoning made a lot of sense to me. By using this term, the child is being told they might be undeveloped. This is certainly not a very enabling way of talking about children.
What it seems to boil down to in my opinion is that those of us who did not develop into the full malehood are now simply underdeveloped people and children. This keeps the category “male” even safer and harder to attain, even though many of us identify as male or live as male.
I think that those of us in the intersex community who disagree with this sexist politicization of intersex infants and their bodies have a right to speak out. Others have the right to speak for children also, not just a select few.
In my opinion, being deranged, deformed, of the wrong sex, and undeveloped does not help infants and children. Dare to speak up for them. Dare to speak the sex that dare not speak its name – INTERSEX.
Footnotes:
(1) Mercks definition of disorder is found at
http://tinyurl.com/7flku
(2) "Parents and doctors are not going to want to give a child a label with a politicized meaning." From ISNA's article on why they are using the term DSD (Disorder of Sex Developtment) found at
http://www.isna.org/node/1066
Sunday, September 17, 2006
Handbook for Parents is transphobic and homophobic
by Curtis E. Hinkle
The Consortium for the Management of Disorders of Sex Development in Children has published a handbook specifically for parents of children born intersexed or as the Consortium prefers to call them – disordered in their sex development. It is very revealing that the consortium has published handbooks for doctors and for parents but nothing for the actual child. There is a reason for this. The Consortium serves the interests of the two groups just mentioned at the expense of the child being managed.
This Handbook for Parents is very misleading and gives parents a lot of misinformation about intersexed children. It minimizes the suffering and trauma that many have reported over the years about being assigned the wrong gender and also being persecuted for being lesbian or gay. The propaganda in this handbook repeatedly brushes aside the serious issues of transphobia and homophobia which many of intersexed people have experienced from their earliest years and throughout life. The handbook is not about making intersexed children actually feel secure and comfortable with themselves but more about assuring the parents that their intersexed children will most likely NOT be transsexual or homosexual.
The Consortium has heralded these publications as advances in the healthcare of intersex children and not about "gender". However, if one takes the time to read the Handbook for Parents, that is all it is about – gender. And how could it be about much of anything else? The whole reason for combining a lot of different conditions which have nothing in common medically under the umbrella term “disorder of sex development” is not to treat real health conditions of intersexed children but to relieve the sufferings and anxieties that gender "ambiguity" provokes within society.
The introduction of the Handbook for Parents makes this very clear:
‘’This handbook does not include a large amount of medical information about your child’s specific condition. That is because there are many conditions that count as disorders of sex development (DSDs), so it would be impossible for us to cover them all. Instead, this book is meant to give you some basic information about sex and gender development.’’
The actual research on intersexed children is not truthfully dealt with in this handbook and one needs to ask why. The actual experiences of thousands of intersexed adults are not dealt with either. Many intersexed adults have denounced not only the early, barbaric treatments but also the very reason for the treatments – to assign a gender without consent or input from the child. Many have also denounced the homophobia that they were subjected to in childhood and later in life. Their narratives and personal experiences are almost invisible and actually trivialized in this handbook so as to give comfort to parents who most likely do not want homosexual or transsexual children.
Parents should be told truthfully that their intersex child is more likely to reject the imposed sex assignment and they should be prepared for just how difficult it will be in most states to do this, if not outright impossible. They should be prepared to cope with the intense trauma and psychological damage that adults have reported who are transsexual or intersexed and assigned the wrong sex. They should be prepared to deal with the very large number of intersexed people who have felt very damaged by the gender they were assigned and there are many of them and more and more are coming forward each day.
We also know that intersexed adults are much more likely to be lesbian or gay and this should not be trivialized or brushed off as it is in this manual. The mistreatment that young children are subjected to who are homosexual is not dealt with adequately and since the parents are usually heterosexual, they are probably not able to understand the long-term damage that many lesbians and gays have reported from such abusive treatment and prejudice they experienced growing up.
One of the most glaring contradictions between the handbook for parents and the handbook for doctors of intersexed infants is rooted in the very transphobia which permeates these documents. The Handbook for Parents repeatedly states that we do not know what determines a child’s gender identity. The Handbook for Doctors repeatedly assures other doctors who are assigning the gender of intersex infants that they can do this quite easily by simply following the guidelines based on the intersex condition of the infant. How could we have no clue what determines gender identity on the one hand and on the other be so sure that doctors can determine the gender arbitrarily by following the guidelines of the DSD experts? Well, it is quite simple. It is always the child who is disordered in these handbooks. If the intersex child rejects the arbitrary sex assignment, they have another disorder. What started out as a disorder of the child’s sex has become a disorder of the child’s gender and the doctors are still totally correct at all points of the treatment protocols and the child is always wrong and suffering from a disorder.
Another interesting transphobic detail, other than constantly asserting that intersex children almost never reject their sex assignment, is expressed when we read that in very rare cases the child may grow up and seek a sex change along with surgical and hormone treatments. Nowhere does this expert mention the most likely fact that the adult had already been altered in childhood without consent. An interesting omission because these earlier procedures can have severe consequences later in life by totally altering the genitalia and sensitive tissue and/or hormonal balance making adult reassignment much more difficult.
This document does not prepare parents for the problems that normalization often causes such as post traumatic stress and other psychological damage to the child. What is so tragic is that in this handbook for parents the disorder is always in the child and the parents are given the false impression that all will be well, i.e., that most likely their child will not be gay or trans. Many intersexed adults feel that the parents would be better served by learning to deal with their own prejudices if they have any and embracing the richness of identities within the intersex community. Those identities are conspicuously absent in this handbook because the subtext of homophobia and transphobia make it almost impossible to not think that part of the normalization process is to prevent other “disorders” also.
The Consortium for the Management of Disorders of Sex Development in Children has published a handbook specifically for parents of children born intersexed or as the Consortium prefers to call them – disordered in their sex development. It is very revealing that the consortium has published handbooks for doctors and for parents but nothing for the actual child. There is a reason for this. The Consortium serves the interests of the two groups just mentioned at the expense of the child being managed.
This Handbook for Parents is very misleading and gives parents a lot of misinformation about intersexed children. It minimizes the suffering and trauma that many have reported over the years about being assigned the wrong gender and also being persecuted for being lesbian or gay. The propaganda in this handbook repeatedly brushes aside the serious issues of transphobia and homophobia which many of intersexed people have experienced from their earliest years and throughout life. The handbook is not about making intersexed children actually feel secure and comfortable with themselves but more about assuring the parents that their intersexed children will most likely NOT be transsexual or homosexual.
The Consortium has heralded these publications as advances in the healthcare of intersex children and not about "gender". However, if one takes the time to read the Handbook for Parents, that is all it is about – gender. And how could it be about much of anything else? The whole reason for combining a lot of different conditions which have nothing in common medically under the umbrella term “disorder of sex development” is not to treat real health conditions of intersexed children but to relieve the sufferings and anxieties that gender "ambiguity" provokes within society.
The introduction of the Handbook for Parents makes this very clear:
‘’This handbook does not include a large amount of medical information about your child’s specific condition. That is because there are many conditions that count as disorders of sex development (DSDs), so it would be impossible for us to cover them all. Instead, this book is meant to give you some basic information about sex and gender development.’’
The actual research on intersexed children is not truthfully dealt with in this handbook and one needs to ask why. The actual experiences of thousands of intersexed adults are not dealt with either. Many intersexed adults have denounced not only the early, barbaric treatments but also the very reason for the treatments – to assign a gender without consent or input from the child. Many have also denounced the homophobia that they were subjected to in childhood and later in life. Their narratives and personal experiences are almost invisible and actually trivialized in this handbook so as to give comfort to parents who most likely do not want homosexual or transsexual children.
Parents should be told truthfully that their intersex child is more likely to reject the imposed sex assignment and they should be prepared for just how difficult it will be in most states to do this, if not outright impossible. They should be prepared to cope with the intense trauma and psychological damage that adults have reported who are transsexual or intersexed and assigned the wrong sex. They should be prepared to deal with the very large number of intersexed people who have felt very damaged by the gender they were assigned and there are many of them and more and more are coming forward each day.
We also know that intersexed adults are much more likely to be lesbian or gay and this should not be trivialized or brushed off as it is in this manual. The mistreatment that young children are subjected to who are homosexual is not dealt with adequately and since the parents are usually heterosexual, they are probably not able to understand the long-term damage that many lesbians and gays have reported from such abusive treatment and prejudice they experienced growing up.
One of the most glaring contradictions between the handbook for parents and the handbook for doctors of intersexed infants is rooted in the very transphobia which permeates these documents. The Handbook for Parents repeatedly states that we do not know what determines a child’s gender identity. The Handbook for Doctors repeatedly assures other doctors who are assigning the gender of intersex infants that they can do this quite easily by simply following the guidelines based on the intersex condition of the infant. How could we have no clue what determines gender identity on the one hand and on the other be so sure that doctors can determine the gender arbitrarily by following the guidelines of the DSD experts? Well, it is quite simple. It is always the child who is disordered in these handbooks. If the intersex child rejects the arbitrary sex assignment, they have another disorder. What started out as a disorder of the child’s sex has become a disorder of the child’s gender and the doctors are still totally correct at all points of the treatment protocols and the child is always wrong and suffering from a disorder.
Another interesting transphobic detail, other than constantly asserting that intersex children almost never reject their sex assignment, is expressed when we read that in very rare cases the child may grow up and seek a sex change along with surgical and hormone treatments. Nowhere does this expert mention the most likely fact that the adult had already been altered in childhood without consent. An interesting omission because these earlier procedures can have severe consequences later in life by totally altering the genitalia and sensitive tissue and/or hormonal balance making adult reassignment much more difficult.
This document does not prepare parents for the problems that normalization often causes such as post traumatic stress and other psychological damage to the child. What is so tragic is that in this handbook for parents the disorder is always in the child and the parents are given the false impression that all will be well, i.e., that most likely their child will not be gay or trans. Many intersexed adults feel that the parents would be better served by learning to deal with their own prejudices if they have any and embracing the richness of identities within the intersex community. Those identities are conspicuously absent in this handbook because the subtext of homophobia and transphobia make it almost impossible to not think that part of the normalization process is to prevent other “disorders” also.
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