This week, The Atlantic published Should We “Fix” Intersex Children?
When I hear stories like the ones told here, I want to find those children and cuddle them; then I remember that I’m so heartbroken because their bodies were invaded and hurt without their say-so,, so it’s better not to want to cuddle, but to tell them I’m so sorry that happened.
Actually, I want to offer comfort to any child who’s had medically unnecessary surgery. I’m not a medical practitioner, and most definitions of medical necessity out there revolve around what insurance will and won’t cover, so I’m defining medically necessary for my purposes, as any procedure needed to save a person’s life or significantly improve their functioning. So, as in the case of Aliya’s son, the urethra not being in the usual place isn’t a reason for surgical intervention, unless the urethra doesn’t function in a way that’ll carry urine out of the body. And no, not being able to pee standing up, in the “manly” way, doesn’t count as reduced function.
Surgery is stressful. Surgery is traumatic.
Not understanding what’s happening to your body is terrifying, and that fear doesn’t leave once the bad time is over.
It doesn’t matter whether a child can consciously remember the surgery. It, like abuse, leaves its imprint on the body and psyche.
This isn’t just rhetoric here; I know what I’m talking about.
Between my birth and shortly after my fifteenth birthday, I went through over 20 surgeries. Most of them were on my head and face. None of them were genitally related. I remember few of them. All of those surgeries were necessary to my survival and my functioning, but I also know the toll they’ve left on my mind and body. There are only so many times you can take a body apart and put it back together again before it just doesn’t feel right or function cohesively.
To leave that toll just because a child’s body doesn’t conform to arbitrary gender or attractiveness standards is violence.
Adults are free to get whatever cosmetic or medical surgeries that aren’t strictly necessary they want. Yes, we could fault beauty norms for pushing some adults into thinking that they have to have surgery to improve themselves, but ultimately they have choices, and are free to exercise those choices.
Children aren’t given those choices. Babies and very little children aren’t able to make such choices. Children’s bodies are growing and changing—should not be interfered with unless interference is needed for survival and healthy growth. If it’s possible to facilitate a child being able to breathe, talk, walk, and otherwise move their body without inflicting lasting harm, then certainly that can and should be done. That’s what I mean by healthy growth.
”The journalistic integrity in this article, presenting as many views and realities as possible, is wonderful, but I am not swayed.
We must not take the bodies of little children apart just to put them back together the way we think they should go.
The validation for surgery on intersex babies came from a psychologist named John Money.
This was the result of his experiment with which doctors have justified operating on intersex children.
One of the medical establishment’s goals is to prevent disability and illness. The Hippocratic Oath commits healthcare providers to never do harm.* How then can medicine, as a whole, ethically justify procedures that can cause physical or psychological disability.
Medically unnecessary surgery disables children. It can lead to chronic pain, nerve damage, and injury as a child’s body grows out of the procedure–physical disabilities that wouldn’t have been there had the surgery not happened. Gender dysphoria, and the sense of bodily violation, can lead to mental health difficulties like anxiety, depression, and thoughts of self-harm. Yes, medical treatments can be experienced as violations. That’s why I call it medical violence.
We should not be disabling children. The fact that the justification for disabling children in this way came from an experiment that harmed a child–a human being–so greatly is horrifying.
As to whether children should have genital-normalizing surgeries to protect them from bullying: People—children and adults–will always, always find something to bully about. That’s not going to change. Submitting a child to surgery with unknowable results isn’t going to change social structures or the bullying problem. (I was going to say that surgery wouldn’t change human nature—which is also true—but I believe that the pervasiveness and escalation of bullying have much more to do with social structures than human nature.
I’d argue too that every child deserves privacy, including privacy from other children, so that if they don’t want to, or don’t feel safe with, showing their bodies to their peers, they don’t have to. It’s ridiculous, actually, that on one hand adults preach to children about modesty while on the other hand children are not given the chance to practice any form of modesty if they wish too.
I should clarify here that I don’t think there’s anything bad or immodest about bodies, or about being unclothed around other people in contexts where that makes sense—like locker rooms. What I take issue with is the contradictory messaging children are given around privacy, and the lack of options for children to make decisions around their own bodies. It’s shameful how little bodily autonomy children are allowed.
The tendency to bully around difference is a massive topic requiring another post, but again, people will always find difference, even if it’s not staring them in the face.
So, if we don’t do genital surgery on intersex children, what do we do about assigning gender? I don’t know. I’d like to think that we could just raise children in a non-gendered, or maybe a multi-gendered, way until, or if, they choose a gender for themselves. Most Western and westernized cultures are so dependent on the gender binary, for everything from naming children to assigning them to sports teams and other recreational activities, that my wee brain just can’t quite envision how these cultures could move past this tendency to raise children without actions that lock their existence into a gender binary. I wish I had that kind of expansive imagination, and even more that if I had that imagination it could make real cultural change.**
The only thing I know for certain is that hurting children is bad, and that having a medical degree and seeing genitals that don’t fit what your textbooks tell you is normal is not a free pass for causing hurt.
*For a modern version of the Hippocratic Oath, take a look here.
** Someone did have that kind of expansive imagination.