Summary
Fausto-Sterling explores the different factors associated with the development of gender identity and sexual orientation from birth onward, such as the presence (or absence) of primary/secondary sex characteristics, pre- and post-natal hormonal therapy, and social environment. Anecdotes about intersexual children show that neither nature nor nurture can be pinpointed as a root cause in identity, as some stick with their reshaped gender or sex and some go through a transformative period where they “revert” back due to hormonal changes during puberty. She also focuses on the initial determinant of sex and the decision for (re)assignment surgery in intersexual babies, namely the personal beliefs of the lead doctor at the time of birth. Though it may seem that the initial decision is made with the intention that the child will remain the assigned sex, Fausto-Sterling repeatedly shows that it might matter very little for gender/sex orientation, in the long run, what sex the child starts their life with.
Reflection
Doctors’ personal beliefs ended up being the key determining factor in assigning a sex - as stated, most were not properly trained in sex education to make an informed decision and their bias ultimately decided whether a child would start their life as a boy or a girl. As with any ethical decision, there always seems like there can be a “better way.” The way Fausto-Sterling presents it, it appears that these decisions are made more with the doctors’ and parents’ wellness in mind than the child’s own psychological well-being. As queerness has become a more outspoken topic and more accepted in mainstream culture throughout the years, this seems like a selfish and outdated practice. In a society where the statistical majority of the population identifies as either male or female, man or woman, there is pressure to push a child into either of these dichotomies. We haven’t discussed this topic much yet, but I’m curious about the effect parents’ attitudes towards their child’s gender and/or sex has on their psychological development, and whether or not pushing the child into one of those divisions from the start causes more harm than good.
Questions:
- Does imposing sex on a child as soon as possible (i.e. within 24 hours after birth) hinder identity development?
- Why is raising a child as intersexual not considered an option?
Re: Why is raising as intersexual not considered an option?
ReplyDeleteThere is this (accurate or inaccurate) belief than an intersex child will not have the same privileges/advantages (social, mental, emotional, developmental, etc.) that a non-intersex child might have. The child and the parents may face "nosy neighbors" and confusion from doctors, which, show in the article, can lead to extremely harmful medical diagnoses and procedures. That being said, it was really interesting to me that the only person who was lied to about their sex and the history behind it was the child. The parents more or less knew about the procedures as well as their child's ambiguous genitalia (though their knowledge may have been altered by the doctors' "half-truths" and "outright lies"). Additionally, I would hope that something like "abnormal" chromosomes and neonatal surgical procedures would be recorded in the child's medical history file, so any of the child's future doctors would know that the child was/is intersex. What is the purpose of keeping this secret from the person whose life is most greatly altered by it?
I was thinking about this too. I got the sense that doctors and parents were keeping intersex people's medical histories secret from them because they wanted to spare them from feeling like outsiders or freaks. Wouldn't it be better to be open with your child about their ambiguous sex assignment from the start, rather than running the risk that they'll find out at some point and be hurt/angry/upset that you lied to them for so long?
DeleteIt's possible that the general parental aversion to discussing anything sex-related with children plays a factor as well. It's been my impression that only kids with access to very good sex ed at school (or with particularly open-minded parents) have any idea what's going on between their legs. Again, this is appealing more to the parents' comfort level than the child's mental and physical health. Intersex kids don't need a detailed description of their sexual organs, but I think open and honest communication early on can lead to a much healthier development of sexual identity.
DeleteAt the same time, the reason this literature CAN exist is because of the very use and spectaclization of this aspect of sex. The images and studies that litter this text are only allowed because someone saw fit to operationalize intersexuality. When you can talk of "giving detailed description of their sexual organs" the text suggests that would only be allowed through invasive surgical intervention. This aversion seems to me in a large part a desire to hide it away, to reinforce comfortable social norms yet this runs up of course with the circus-freak phenomenon present throughout. It seems there is a consistent desire to erase otherness while to confirm sameness through its example, and that while the medical practice plays a large roll in this a "parents discomfort" is no better an excuse. That being said, if your doctor is holding back information, telling you this is urgent, are you necessarily going to know better? IF doctors don't even know if support groups exist, how will you know how to address this to your kid? What sort of power over the literal bodies has this parent-doctor consortium been given?
DeleteDoes imposing sex on a child as soon as possible (i.e. within 24 hours after birth) hinder identity development?
ReplyDeleteWhile sex and gender are different and separate parts of an individual's identity, many people don't understand the differences between the two. In that sense, imposing a sex on a child at birth is similar to imposing a gender. Because my sex is female, I've been told since birth that I am a girl. I do identify as a woman, but our culture leaves little room for a child's sex and gender to not be imposed on them from birth. There are obviously differences between the imposition of gender (my experience) and the imposition of sex (an intersex child's experience), mainly that the imposition of sex includes the altering of genitalia. However, in a world that often combines sex and gender, imposition of one or the other is certain to occur. Our culture, which fixates on a gender binary, inherently hinders identity development by enforcing the idea that sex and gender are the same concept and that only two genders exist. Therefore, while imposing a sex on an intersex child cannot help identity development, it does not hinder it more than our society's beliefs.
OK so a lot of emotions and mixed thoughts, but i hope i can respond in a helpful manor or one that makes sense.
ReplyDeleteFirst I want to say, I imagine it would be really hard for parents to make these kinds of decisions; "Do I pick a sex for the baby?" "Which sex should I choose?" "Am I even making the right decision?!" Must be incredibly strenuous and terrifying, because what if the path changes and the parent(s) feel(s) guilty or regretful later? Even if the parent(s) DO(ES) inform the child later on.. which is why mixed emotions/thoughts come in for me.
Part of me feels if I were a parent I would initially panic and feel PRESSURED to choose in those 24 hours because, yes, parents fear for their child's safety, well-being, etc. and each sex has their own "set" dangers, pressures, and stress historically and biologically (i hope i used the correct word) speaking. After some calming down and time though I would HOPE my morals and beliefs would kick in, which come down to this: I think imposing or forcing a sex is wrong, and why would it be such a bad thing to have an intersex child? I do understand the difference between sex and gender and that no matter the sex of a person his/her/their gender could be similar or very different, so i follow what you have said Katherine. Choosing a sex in that 24 hrs maybe would NOT be SO the end of the world because my child would develop his/her/their own identity regardless.... but i don't know, I just think that I would want my child to be educated and have the option to choose a sex and make the decision whether or not to have surgery to fit his/her/their gender or how he/she/they see themselves.
**i realized i made a mistake when i was expressing my morals and beliefs. The second question meant to read, "and why would it be such a bad thing to have a child of both sexes?"
DeleteI agree and I definitely think telling a child "you're a girl" or "you're a boy" 100000 times affects the development of their identity. The child may be the same core person all in all, but with more socialized masculine or feminine characteristics. I wonder though, how would a child in this time and place feels know they are intersex? In primary school, how would they describe themselves to their peers? School is an especially gendered place, with no place (at the present time) for intersex children. On the other hand, maybe feeling a little awkward and different is better than finding out later in life that your prescribed gender was chosen (almost) at random. It must be a very hard decision for these parents to make, no matter if they are quite liberal or accepting of difference genders.
DeleteI think imposing a sex on a child as soon as possible definitely hinders identity development. If there is a way that the child can still develop in a healthy manner until the child is old enough to express a certain gender, I think the decision should be delayed. This would probably depend on the child's condition (perhaps surgery is necessary either way), however in most cases I think reconstructive surgery that will be either irreversible or extremely difficult to reverse should be avoided. I agree with comments above that reluctance to raise a gender neutral child mostly come from society's reliance on a gender binary. It would be difficult for parents to explain themselves, but soon enough the child would be able to express themselves and perhaps a decision could be made during childhood, hopefully avoiding extreme gender dissonance. There are plenty of great reasons to raise a gender neutral child anyway, so doing so for an intersex child makes sense to me.
ReplyDeleteI agree with the comments above. For the parents, everything surrounding having children sees to be centered around the gender binary - from receiving gender-specific clothes and toys at baby showers to decorating the baby's room and so on. Judith Butler's discussion of gender as "compulsory" comes to mind; even though this binary is a social construct, there are still real social repercussions for not "fitting in" within the boundaries of that construct. So, while I don't agree with it, I can understand the drive to assign a male or female sex to intersex babies at birth in this context.
ReplyDeleteLike Andrea, I think that other than treating the metabolic problems that Fausto-Sterling mentions, medical intervention should be postponed until the child can make a decision on his/her/their own.
Reading this article, I could not help but appreciate the surprise and anxiety parents shared in the event of having an intersexual baby. The binary system of gender in society can be extremely damaging, but I cannot help but sympathize with parents who are thrust into such a difficult position. I would agree that assigning sex for an intersexual child hinders identity, but I can understand the inclination to do so. If surgery is needed to prevent further health complications, I believe assigning sex to an intersexual child is a necessary decision that should be made by the child’s parents. Physicians who deal with such cases should be trained to provide the best information possible. Parents should not be pressured, and should not be shielded from their child’s medical status. If, on the other hand, the sexual assignment surgery is not very pressing, parents should be allowed adequate time to address their situation. After being informed and seeking advice, they may agree to surgery, or decline if they preferred. In this instance, I would also understand parents assenting to a sex assignment surgery. I feel this would be beneficial to the child emotionally and socially, due to the gender binary that exists in our culture. This gender binary is repressive to those who do not abide by its rules, but parents cannot ignore its influence on their child’s life. Parents feel pressured into making a decision for their child due to this gender binary. This is why having an intersex child does not seem to be an option. The institution of gender in society surrounds us all, thus having a child that does not fit nicely in the gender binary is understandably shocking and unsettling for some. The notion that having an intersex child is not an option simply pays homage to the existence of, and strict adherence to, the gender system in our culture.
ReplyDeleteWhile I understand with a lot of the concern people are expressing over parents having to make difficult decisions regarding the gender in which to raise their intersex child, I am having a hard time understanding how parenting an intersex child and parenting a child with easily defined genitals is all that different, if we we assume that the social construction of gender is true. Because I believe that gender is a social construction, it only seems appropriate to raise a child with full access to activities and objects culturally assigned to all genders, regardless of whats in between their legs. There are stories all over the internet of parents talking about their gender bending toddlers and kids who go to kindergarten expressing an incredible variety of gender orientations. It doesn't take very long, and the process is also so flexible that many kids will make gender transitions in their young lives. Thus, to me, the only issue that a parent really needs to worry about is sexual function and pleasure. "Correcting" genitalia to look neater or nicer or more toward one end of the sex binary extremes with little to no regard for function, practically or pleasure-based or otherwise, seems, at least to me, to be the primary issue. Preventing needless, mindless surgery on a little infant should be the primary concern to parents.
ReplyDelete- Does imposing sex on a child as soon as possible (i.e. within 24 hours after birth) hinder identity development?
ReplyDeleteI think imposing sex so early, or at all, is detrimental to personal identity development. Especially based on how the article detailed doctors' methods in doing this, it seems to me that the best way to determine sex is to let an intersex child determine gender with as little societal constraint as possible. Obviously, this would be incredibly difficult in the society we live in, but I believe that parents should at least be open to letting a child explore their gender if presented with a situation described in the article.
I also thought it was interesting that doctors still seemed to have such a preoccupation with genital size in determining whether or not an infant was "male enough" even though there was evidence that the correlation between penis size at birth and penis size at puberty was not that strong.
I don't think imposing gender on a child hinders identity development. As one of the doctors opposing Dr. Money, children will develop into their identity whether or not doctors, parents, or society accepts it. No matter how hard people try to oppress anyone (in this case hiding gender identity from the children) it doesn't work. Nature has a way of getting out.
ReplyDeleteThis article was a good read which made me very angry. The explanations of the way doctors assign a child’s sex and the whole idea that a child must be assigned a sex within 24 hours of birth is so absurd. Early views of intersex treatment suggest that “goal of treatment was to assure proper psychosexual development”, as put forth by John Money (46). This, along with many other treatment goals of surgery (including attempts to ensure the surgery would ensure the individual would be heterosexual), are horribly wrong and are incorrect grounds for performing detrimental surgeries on an infant whom has no choice as to what they are assigned at birth. Doctors, even still today, base their decisions on how to assign an intersex child based off of their own opinions. Other doctors make their decisions based of the existing reproductive structures the infant is born with; if child has the potential to reproduce in the future, the infant is assigned female, but if the existing genitalia has the potential provide the individual with pleasure/engage in penetrative intercourse, the infant is assigned male. Once again, such decisions based off of our cultural beliefs of gender and sexuality are detrimental to the many individuals who fall outside of what is considered “normal”.
ReplyDeleteAnother huge issue which bothers infuriates me is the available info doctors provide parents when they ask them to select which genitals they want their child to have. As Fausto-Sterling points out, doctors do not explain that the child is a “mixture of male and female”, but rather that “the intersex child is clearly either male or female, but that embryonic development has been incomplete” (64). I’m honestly so disgusted and outraged by this. All information should be available to the parents of the infant that was born. It is not acceptable for doctors to be distorting factual information in order to keep the parents and the rest of society from feeling confused or anxious about the so called non-conformities of an individual’s identity. Also, like many others have already mentioned on this blog, I believe that the whole concept of assigning a sex to an infant within 24 hours of leaving the hospital is ridiculous. Yes, it may temporarily settle the fear of the unknown for parents of the child, but overall, it can hinder so many aspects of the child’s life (including sexual functioning, the ability to feel sexual pleasure, future gender dysphoria, etc.). Would it be possible to raise an intersex child in this day and age? I believe it is, though there are a decent number of difficulties that could be present along with way (as prejudice is commonly faced by any minorities in our society). All humans start out with the same potential to become “male” or “female” in the womb, and as Fausto-Sterling says, this is “not only natural… but normal” (76). No amount of prenatal hormones can influence the development of gender identity. So the whole notion of assigning a neutral individual a set identity, which will then alter the way society treats them, seems unfair. The whole concept of the sex and gender binary is endangering the well-being of humans born with genitalia that doesn’t strictly appear to be one binary sex or the other, and this needs to be stopped.
A novel I just read, "Middlesex" by Jefferey Eugenides, explores the very topic of intersexuality (If you plan on reading this book skip my spoiler-filled synopsis). The main protagonist, Cal, was raised as a girl. However, during puberty Cal discovers that it is more complicated than that. Because of historic familial incest, Cal has a condition known as 5-alpha-reductase deficiency. This means Cal has female characteristics but rather ambiguous genitalia. Her parents take her to a specialist in New York City, and after a full investigation a doctor determines that Cal asserts a female gender identity. The doctor plans to reconfigure her biological sex in order to conform with what he believes is her "proper" gender. Just as Fausto-Sterling discussed, the surgery is posed as a minor correction to biological development, but Cal researches it herself and discovers that she is in fact male. In a crucial point in the novel, she becomes cognizant of her "true" male gender identity. She runs away before the surgery, abandoning her family and transitions to a life as a presented male. She lives out the rest of her life presenting as a male. However, she experiences extreme anxiety in developing romantic/sexual relationships.
ReplyDeleteWhile this is a rather simplistic synopsis of a truly fantastic book, it begs the questions, how does our cultural assumptions of dichotomous gender influence our understanding of the male/female binary? Additionally, if someone chooses to not conform wholly to either gender category, how do they live in our extremely gendered society? Which box does Cal check when applying for a passport?
The thematic concepts of intersexuality and gender noncomformity from "Middlesex" are especially fascinating because of how popular this book became when it came out in 2002. It was featured on the famed Oprah's Book Club and received critical praise, even winning a Pullitzer Prize. How does such popular reception of a novel depicting intersexuality change people's socialized assumptions of the sex binary? Is there something problematic about the author (a cis-gendered heterosexual male) profiting from the very real lived experiences of oppressed people? Personally, I think "Middlesex" entering mainstream literature is a step in the right direction in elucidating intersexuality and exposing the problematic nature of imposing sex on intersexual babies.
Why it's such a problem to be intersex in the first place is an entirely different concern that I don't fully grasp. Perhaps societal implications? However, the biggest red flag here, for me, is the blatant disregard for the child in this scenario. They are fed lies from birth, and while those lies might come with good intentions, it is still beyond me that adhering to society's beliefs and appeasing the rest of the world could come before a child's happiness and personal identity. Every parent (arguably) wants the best for their child; are they afraid that without a defined sex, the child will not, or cannot, be happy? Successful? While a newborn clearly cannot make that decision for themselves, I think much more consideration should go into the process before imposing sex (or even not!) on an intersexual baby. Doctors should inform the parents to the greatest extent and time should be taken as needed in order to make the most well-informed decision possible, and the child should certainly have access to that information once capable of understanding it.
ReplyDelete