These ethics of gender assignment for children born with intersex conditions were presented by William Reiner, M.D. at the Duckett Memorial Lecture, University of Michigan, July 21, 2000. Dr. Reiner is a physician in the Division of Child Psychiatry and in the Division of Pediatric Urology at Johns Hopkins University. The title of Dr. Reiner’s talk was “How I learned to Stop Worrying and Love the Unknown.”
- Sex assignment is never emergent or urgent.
- We cannot manufacture unambiguous data to replace real ambiguity.
- We are not medical experts if we do not know the outcome and the good of our proposed medical procedures.
But does the Urology Department listen to the Psychiatry Department?
“For children with birth defects the most rational approach at this moment is to correct promptly any of the major urological defects they face, but to postpone any decision about sexual identity until much later, while raising the child according to its genetic sex. Medical caretakers and parents can strive to make the child aware that aspects of sexual identity will emerge as he or she grows. Settling on what to do about it should await maturation and the child’s appreciation of his or her own identity.”
Paul McHugh is University Distinguished Service Professor of Psychiatry at Johns Hopkins University.
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.
The June 2007 issue of Scientific American features a profile of Eric Vilain MD (a world renowned genetic researcher, pediatric endocrinologist, and member of ISNA’s Medical Advisory Board). The article, Going beyond X and Y, discusses the recent international medical consensus which agreed to drop the term “hermaphrodite” in favor of the more neutral “disorders of sex development” (DSD).
Date: Sat, 17 Mar 2001 17:36:14 -0500
To: “ISNA News (multiple recipients in Boston area)”
From: Cheryl Chase
Subject: Eve Ensler in Boston: Help us educate her!
Hi, All you ISNA correspondents in Greater Boston area!
Please help us to educate Eve Ensler! She’s coming to Boston this month!
You’ve probably heard of The Vagina Monologues. You may not know that
the book and play promotes the idea that clitorectomy occurs in
Africa, or perhaps a long time ago in America, but not here and now
(page 66 in the V-Day edition). There’s also a dreadful line in the
Vaginal surgery generally requires a kind of post-operative care called “vaginal dilatation.” After surgery, the tissue tends to get smaller while healing. In order to keep the vaginal opening from closing up, the patient (or her mother or a doctor, in the case of an infant or child) is instructed to insert an object into the vagina, pressing against the scar tissue, on a regular basis.
When performed on a child, vaginal dilitation can be emotionally scarring for both child and parent. This is one reason why many experts recommend that vaginal surgery not be performed on children with DSDs (Disorders of Sex Development) — rather, it should be made available to patients who are at least adolescent, who can understand the reasons for the procedure, and who can do the necessary vaginal dilitations themselves (if the patient is not motivated to do this, then the surgery should obviously not be performed). The surgeon’s argument that vaginoplasty can be completed with a one-stage procedure on an infant has been roundly refuted — follow up surgery will almost always be required as the patient enters adolescence. Avoiding vaginal surgery on infants and children also allows for the patient (as an adolescent or adult) to try manual pressure dilation, which has been quite successful for many women who escaped vaginoplasty.
On October 11, Emi Koyama from Intersex Society of North America will present a lecture titled "Intersexions: Mapping Intersex Activism within Progressive Social-Change Movements" at Washington State University in Pullman, WA. The event will take place at WSU Fine Arts Auditorium at 7 pm, and is part of WSU's Gay, Lesbian, Bisexual and Transgender History Month.