SPATE OF NEW INTERSEX ARTICLES IN PROFESSIONAL MED LITERATURE

Classification: News

For Immediate Release

September 9, 1999

Contact: Cheryl Chase <cchase@isna.org>

 

SPATE OF NEW INTERSEX ARTICLES IN PROFESSIONAL

MEDICAL LITERATURE

 

Ann Arbor, MI -- Until just a few years, ago doctors

who specialized in handling intersexed (children

born with atypical sex anatomy -- often labeled with

the quaint and misleading medical anachronism

"hermaphrodite") were confident that they knew

what to do. In a model developed in U.S. in the 1950s,

intersexuality was so disturbing that only doctors

could deal with it. Intersexed patients and their

families could be helped only if doctors used every

tool at their disposal to eliminate ambiguity, and as

quickly as possible.

 

The past six years, however, have witnessed a

burgeoning, vocal, and articulate opposition to these

medical protocols. The opposition comes from

intersexed adults who feel they have been harmed by

misguided and unscientific medical treatment, and

from their allies in a wide variety of disciplines,

including medicine, ethics, history, sociology,

philosophy, psychology, anthropology, and law.

 

At last the medical literature has begun to

acknowledge the growing controversy surrounding

the standard treatment for intersex births.

Physician's Weekly, in August, carried a short debate

over the advisibility of cosmetic genital surgery on

infants, between pediatric endocrinologists Peter Lee

(Pro) and Philip Gruppuso (Con).

 

The highly respected and influential UCSF pediatric

endocrine duo Melvin Grumbach and Felix Conte

announced, in a recent Journal of Pediatrics article,

that they no longer recommend that a particular

category of boys born with small penises be changed

into girls during infancy. An accompanying

editorial by Jud Van Wyk, also a well known name in

pediatric endocrinology, mentions the influence of

former patients organized to stop the surgeries, but

fails to provide an accurate name or citation which

would allow readers to contact ISNA or other support

groups.

 

British physician Alizai and colleagues, in the May

issue of the Journal of Urology, report that they have

done a long-term follow up of 14 teenaged girls had

been subjected to genital surgery during infancy to

remove parts of their clitorises and make their

vaginas more suitable for heterosexual intercourse.

They discovered poor results in terms of appearance

and scarring. Because the girls were examined under

anesthesia, it does not appear that sensation or sexual

response were evaluated. Nonetheless, the authors

characterize the outcome of genital surgery as

"disappointing," even when the surgery is

performed by specialists. They call for an end to

some cosmetic genital surgery on infants.

 

The July/August issue of Pediatric Nursing carries

an article by intersex activist Cheryl Chase. Chase

was solicited by the journal's ethics editor, who was

disturbed by an earlier article which gave strong

consideration to using the courts to impose surgical

sex change on an infant whose parents opposed it. Of

note, the article is illustrated with a photo of

intersexed activists who appear in a group, clothed,

smiling and without their eyes blacked out.

 

"As much as we would like to think that . . . we always

assign an appropriate gender to an infant with

ambiguous genitalia, mistakes are inevitable,"

concedes surgeon Kenneth Glassberg, in a Journal of

Urology editorial. Unfortunately, he conflates

surgery with sex assignment, equating calls for

deferral of surgery to some sort of demand for public

assignment of children as hermaprhodites. Glassberg

cites one ISNA publication, but appears not to have

understood that the article he cites is satire, and the

citation he provides is grossly inaccurate and

inadequate, thus preventing his readers (including

intersexed former patients) from gaining access to

first person narratives by intersexed people.

 

"We live in an age of increasing respect for minority

rights," notes surgeon Ian Aaronson, in an editorial

on "The Child with Ambiguous Genitalia" in the

Journal of Infectious Urology. However, if genital

surgery on infants were to be stopped, and

intersexed children allowed to make choices about

their own lives, it would "signify a return to the

'dark ages' of intersex management, which has given

rise to a host of psychological cripples."

 

ARTICLES CITED

 

Aaronson, Ian A. 1999. Editorial Comment: When and

How to Screen? Infectious Urology 12 (4):113-118.

http://www.medscape.com/SCP/IIU/1999/v12.n04/u3

010.slav/u3010.slav-07.html.

 

Alizai, N. K., David F. Thomas, R. J. Lilford, A. G.

Batchelor, and Nick Johnson. 1999. Feminizing

genitoplasty for congenital adrenal hyperplasia:

what happens at puberty? Journal of Urology 161

(5):1588-91.

 

Bin-Abbas, Bassam, Felix A. Conte, Melvin M.

Grumbach, and Selna L. Kaplan. 1999. Congenital

hypogonadotropic hypogonadism and micropenis:

Why sex reversal is not indicated. Journal of

Pediatrics 134 (5):579-583.

 

Chase, Cheryl. 1999. Rethinking treatment for

ambiguous genitalia. Pediatric Nursing 25 (4):451-5.

 

Glassberg, Kenneth I. 1999. Editorial: Gender

Assignment and the Pediatric Urologist. Journal of

Urology 161:1308-10.

 

Lee, Peter, and Philip A. Gruppuso. 1999. Should

cosmetic surgery be performed on the genitals of

children born with ambiguous genitals?

(Point/Counterpoint). Physician's Weekly, August 16.

http://www.physiciansweekly.com/archive/99/08_16_99/pc.html.

 

Van Wyk, Jud. 1999. Should boys with micropenis be

raised as girls? Journal of Pediatrics 134 (5):537-538.

 

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The Intersex Society of North America (ISNA)

works to create a world free of shame, secrecy,

and genital mutilation for intersex people. For more

information, visit our web site at http://www.isna.org