Recent Publications

Fuzzy math in Journal of Urology

Classification: Recent Publications

Meyer-Bahlburg, H. F. L., C. J. Migeon, et al. (2004). "Attitudes of adult 46,xy intersex persons to clinical management policies." Journal of Urology 171: 1615-9.

Well, we are pleased that some clinicians are starting to try to talk to their former patients. But they continue to confuse sex assignment and early genital surgery, to use the anachronistic term "unfinished" when referring to genitals with atypical appearance, to imply that any change in policy would require inventing a third sex. Finally, the authors apparently believe that if a simple majority of patients are satisfied with the gender assigned, then current policies are justified and no reform is needed.

Georgetown Law Journal on intersex

Classification: Recent Publications

Lareau, A. C. (2003). "Who decides? Genital-normalizing surgery on intersexed infants." Georgetown Law Journal.

"Those who promote informed consent should recognize the risks and deficiencies in such an approach. Most importantly, efforts such as the ABA resolution should be rephrased to prevent the medical community from construing it as an official legal endorsement of the current treatment model. Such an endorsement could stagnate medical research into the necessity of genital- normalizing surgery, allowing surgeons to simply explain the current lack of knowledge and rely on parents to make a decision."

Getting Rid of "Hermaphroditism" Once and For All

Classification: News | Recent Publications

A new article just published in the Journal of Pediatric Endocrinology and Metabolism makes a compelling case for getting rid of all medical terms based on the root “hermaphrodite.” The authors (including two ISNA staff members and three ISNA Medical Advisory Board members) explain the problems with terms like “pseudo-hermaphroditism” and “true hermaphroditism.”

Why get rid of these terms? Because:

  • These terms are stigmatizing to patients and their families. We should all be working to reduce stigma, not add to it through medical care.

Intersex and Female Genital Cutting

Classification: Recent Publications

The Winter 2005 issue of the Harvard Civil Rights-Civil Liberties Law Review features an article about intersex. The article, entitled Intersex Surgery, Female Genital Cutting, and the Selective Condemnation of ‘Cultural Practices’, discusses the similarities between female genital cutting (FGC) in African and Asian countries and the cosmetic genital surgeries performed on intersex infants in the West. Written by Nancy Ehrenreich with Mark Barr, the article suggests that although people in the West often medicalize the cosmetic genital surgeries currently performed that these procedures, much like FGC, have cultural roots.

ISNA Discussed in "Savage Love"

Classification: Recent Publications

ISNA is mentioned in the famous "Savage Love" advice column of April 14, 2004.

The issue mentioned is familiar: an adult born with intersex who was "sex reassigned" to be female as a child, now wishing the parts s/he was born with were still there.

I've written a note of thanks to Dan Savage ("Savage Love" columnist) and asked him to clarify one thing:

Intersex conditions DO sometimes come with serious underlying health concerns. Therefore anyone who thinks s/he is intersex or that his/her child is intersex SHOULD seek medical advice to rule out (or address) health problems. We do not hesitate to recommend surgeries that address serious health problems (as when a child is born with intersex and no urinary outlet).

Law and Order SVU does John/Joan story

Classification: News | Recent Publications

On Jan. 18, 2005 NBC aired an episode (“Identity”) of Law & Order SVU closely mimicking David Reimer’s story (“the John/Joan case”) as a plot, right down to a vaporized penis, quotes like “easier to dig a hole than build a pole,” secrets and lies and a very unsavory representation of a doctor implicitly modeled after John Money. (Note that John Money is actually a psychologist, not a medical doctor.) If you see it pop up on the tv schedule in re-runs (often on the USA Network), check it out.

Lifting the Curse

Classification: Recent Publications

Groveman, S.A. 2001. Lifting the Curse (letter). Discover, March.

"The Curse of the Garcias" [Vital Signs, December] tells readers about the rare medical condition androgen insensitivity syndrome (AIS). Unfortunately, the one person author Dr. Robert Marion chose not to so educate was his own patient. While Dr. Marion may think he was protecting her by withholding information, he instead placed her at risk of discovering it on her own without appropriate support or counseling. I know how devastating such a discovery can be—I, too, have AIS. And I, too, did not learn about my condition from my physician; I uncovered the truth in a public medical library. Dr. Marion's approach doesn't ensure that his patient won't make a similar discovery. In any event, it denies her the right to make informed choices about her medical care.

Middlesex reviewed in medical journal

Classification: Recent Publications

Bergman, A. (2004). "Middlesex (Book Review)." Archives of Pediatric and Adolescent Medicine 158(5): 500.

"Yes, it is fiction, but I cannot imagine a more authentic and sensitive voice. Because our interactions
usually take place in limited and structured settings such as offices and hospitals, pediatricians have scant opportunity to learn how our young patients think. One way to sharpen our awareness is to listen to children’s voices as they are expressed in books. In Middlesex, the voice is loud and clear."

Miki Ann Dimarco confined in isolation because she's intersexed

Classification: Law | News | Recent Publications

The Casper Wyoming Star Tribune is carrying an article about Miki Ann Dimarco. Early this year, a U.S. District Court judge found that 438 days of confinement in Pod Three, a maximum security four-cell segregated area that is used to house the Wyoming Women’s Center worst inmates, was not cruel an unusual punishment. Dimarco was found guilty of passing six bad checks, totalling $742.85. That’s not why she was confined all alone for over a year. Rather, prison officials decided to segregate her when they discovered that she was intersexed.

Dusen, Matthew Van. 2004. Separate and Unequal. Casper Star Tribune, December 8. Available online.

Physician's Rhetoric and Intersex Management

Classification: Recent Publications

Hester, J. David. 2004. Intersex(es) and alternative strategies of healing. Ethik in der Medizin 16:48-67.
———. 2004. Intersex(es) and informed consent: how physicians' rhetoric constrains choice. Theoretical Medicine 25:21-49.
———. 2003. Rhetoric of the medical management of intersexed children. Genders 38. Available from http://www.genders.org/g38/g38_hester.html.

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