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RE: Dove on Heterosexism.

Mr. Dove displays a number of socially constructed assumptions which are commonly used by medical and biological "experts" to cover up the relatively common practice of genital mutilation in the U.S.

Compare his rhetoric, as a clinician and "expert" to the rhetoric of those he is trying to "save" or "correct." Notice the false construction of problems, errors, and flaws which our doctor/gods will fix for us and the patriarchal nature of the solution.

Mr. Dove writes:
>>>
Calling these developmental abnormalities
"different sexes" is like calling diabetes a "different metabolism."  Yes,
it occurs naturally, but that does not make it "normal?"  I understand the
intent of the organization you cite, which is trying to let those who
suffer from these conditions find an outlet for their anger and adapt to
life in a world not built for them.  It's the same type of emotional
adjustment that anyone "different" has to make, whether they are a
hermaphrodite, paraplegic, or blind.  In this case, because it centers on
sex, it becomes an emotionally charged issue, but I really believe it's no
different.
<<<

Intersex is not (with rare exception) life threatening, or even developmentally worrisome. It is substantially different from diabetes. 

One brave individual which you speak of as "abnormal" so boldly writes in response to Dr. John Money's similarly simplistic and narrow view,
>>>
I beg to differ, Dr. Money. I was born whole and beautiful, but different. The error was not in my body, nor in my sex organs, but in the determination of the culture, carried out by physicians with my parents' permission, to erase my intersexuality. Sex errors is no less stigmatizing than defect or deficiency. Our path to healing lies in embracing our intersexual selves, not in labeling our bodies as having committed some "error."
<<<

Mr. Dove writes:
>>>
Wow, that's a stretch.  Corrective surgery for a birth defect = genital
mutilation?  Realize, please, that in many cases (especially severe
hypospadia), surgery is not optional, at least if you want the patient to
survive.  
<<<

Hardly a stretch. Read the literature. It's clearly genital mutilation.
As for surgery not being optional, this is rarely the case, and most often the surgery performed is COSMETIC (meaning it is done to conform to social expectations). It is easy relatively easy to delineate those cases in which surgery is absolutely essential to survival. This surgery damages the sensitivity of the genitalia and can damage the capacity for sexual pleasure.

The Intersex Society of North America writes:
>>>
Hypospadias is essentially a cosmetic difference. A person with hypospadias may have to urinate sitting, rather than standing. He may also be prone to urinary tract infections.
More important is the emotional impact of having a penis that "looks different." This is why your doctor may advocate surgery for your child's hypospadias. Our discussions with men who have had hypospadias surgery lead us to believe that the physical damage and emotional trauma of genital surgery are frequently far worse than the hypospadias itself.
Hypospadias does not in itself cause infertility. Infertility may be present in the more extreme forms of hypospadias, where the testes are irregular and cannot produce viable sperm. Hypospadias surgery cannot make an infertile male fertile.
A hypospadic penis is entirely capable of pleasurable sexual sensation and orgasm. Plastic surgery on the genitals damages erotic sensation; it cannot improve it. There are some conditions however, which may require surgery to save your child from pain or illness, such as chordee which bends the penis causing painful erections, exposed mucous membrane, or adhesions.
<<<

The Intersex Society Continues:
>>>
Many complications can occur with hypospadias surgery. Unfortunately, it is usually performed on children before puberty, and few doctors do extensive follow up on their hypospadias patients. A young man who finds that his sexual function was irreversibly damaged by surgery during childhood is often too embarrassed to discuss it.
<<<

Again, the Intersex Society writes:
>>>
The urethra, the tube which carries urine and semen out of the penis, is made of mucosal tissue, like the inside of your nose or mouth. This mucosal tissue is designed to resist both the irritating effect of urine, and the growth of bacteria, which would otherwise flourish in such a warm, wet, protected environment.
When surgeons use a flap of skin to construct or extend the urethra, the skin tube that results is poorly equipped to resist irritation from urine, or infection by bacteria. Further, the surgically created urethra is not as smooth as a real urethra, and may grow hair.
Urine may collect in a surgically constructed urethra. Pressure during urination can force urine to escape into the body of the penis. These factors can result in pain and a life-long tendency toward urinary tract infections, which may involve the bladder and kidneys, and become quite serious. The surgical scar can break down, forming fistulae, or holes, in the urethra, resulting in pain and more surgery.
<<<

Finally, the Intersex Society provides this story:
>>>
Before her ill-fated stint as Surgeon General, Joycelyn Elders' specialty was-pediatric endocrinology. An article in last year's The New Yorker quotes Dr. Elders: "If you have a boy thinking he's a girl, then all you can really do is just take out everything and make a good vaginal pouch, and the child can function very well as a female" (emphasis added).
Dr. Elders taught these "rare" surgical procedures at the University of Arkansas. "I always taught my students, 'I can make a good female, but it's very hard to make a male."
The New Yorker writer characterized Dr. Elders as one who appreciates healthy sexual development. She was ultimately dumped as Surgeon General for having the gall to speak openly about healthy masturbation. We wonder if any of the hermaphrodites made into "good females" by Dr. Elders or her students are able to masturbate today.
<<<

Mr. Dove writes:
>>>
I agree that unnecessary medical intervention should be avoided, but this
is not always an easy call.  
<<<

Then you should stand in opposition to the repugnant practice of assigning all children as either male or female, especially at such great expense.

One Intersex Patient writes:
>>>
 I assure readers that this surgical treatment modality was not confined to "the 1960s and early 1970s": it continues today for approximately five children per day of the perhaps 1 in 2000 children born with some anomaly of biological sex differentiation. The ramification of this experiment is not "that dozens of other boys may have been needlessly castrated", it is that thousands of children had, and continue to have, their bodies and their lives mutilated and traumatized by unconsented surgical, hormonal and psychological medical interventions.
<<<

The Intersex Society of North America Writes:
>>>
A new model of treatment
Based on discussions with dozens of adult intersexuals, we are prepared to recommend a new paradigm for the management of intersexual children. Our model is based upon avoidance of harmful or unnecessary surgery, qualified professional mental health care for the intersexual child and his/her family, and empowering the intersexual to understand his/her own status and to choose (or reject) any medical intervention. 
Avoid Surgery
First and foremost, we recommend avoidance of harmful or unnecessary genital surgery on infants and children. No surgery should be performed unless it is absolutely necessary for the physical health and comfort of the intersexual child. We believe any surgery that does not meet these criteria to be essentially elective cosmetic surgery which should be deferred until the intersexual child is able to understand the risks and benefits of the proposed surgery and is able to provide appropriately informed consent.
Examples of such cosmetic surgery to be avoided are plastic repair of first degree epispadias or hypospadias (minor displacement of urethral rls with congenital adrenal hyperplasia who had undergone early surgery to create a cosmetically satisfactory clitoris and external genitalia as well as to separate their "high vagina" from the urogenital sinus. He noted that very few studies have been done to gauge the long-term results of this early feminizing procedure.
The girls, aged 11 to 15 years, were assessed by a pediatric urologist, a gynecologist with extensive knowledge of vaginal reconstruction, and a plastic surgeon. Urogenital sinus was still present in six of the girls, despite the previous vaginoplasties. Two of the six girls who had begun to menstruate showed signs of hematocolpos [accumulation of menstrual blood in the vagina]. Clitoroplasty was deemed unsatisfactory in six girls, with atrophy apparent in five. Several of the clitoral reconstructions were quite visibly different from the original cosmetic result: withered and obviously nonfunctional. "Every girl required some additional vaginal surgery. The results are indifferent and, frankly, disappointing," Dr. Thomas said.
Surprisingly, some of the poor outcomes shouldn't have been the result of surgical inexperience. Although the poorest results were in girls whose original surgery had been performed by nonspecialists, Dr. Thomas pointed out that 70% of the original surgeries had been performed by full-time pediatric urologists in three specialist centers.
The findings caused him to re-evaluate some of his own views on the surgery. "We would certainly not advocate deferring procedures that provide a girl with normal-appearing external genitalia. . . . but no girl in her childhood needs a functioning vagina," he asserted. Because every girl required some sort of further surgery later, Dr. Thomas thinks waiting until after puberty to do definitive vaginoplasty is a good idea. He noted problems and the need for revision especially in the case of girls who had undergone aggressive attempts to repair a "high vagina." Currently, both genitoplasty and vaginoplasty are usually undertaken in infancy at the earliest, and toddlerhood at the latest.
"Scarring and fibrosis ensuing from early vaginal surgery may preclude tissue expansion," Dr. Thomas warned.
<<<


Mr. Dove writes:
>>>
False.  Genetic composition does determine sex.  Social composition
determines gender.  While the surgeon may make a mistake and fix a
deformity in the wrong direction, this is a barrier of technology, not a
fundamental social problem.  When we have more accurate tests for genetic
sex, these decisions can be made intelligently. 
<<<

Ummm... Check the facts. If you're talking about genetic types (XX, XY) know that there are people who cross the borders of this distinction (look into Klinefelter Syndrome, XXY).

Or maybe this was the "accurate test" you referred to...

>From the Vancouver Sun, April 7:
>>>
And the medical response -- however humanitarian in conception, however compassionate in intent -- in most cases is medieval and monstrous in actuality: sexually ambiguous children are turned into girls. It is the beginning of a very real Crying Game. Six or more children a day across North America, Cheryl Chase says, are subjected to clitorectomies.
"Surgery fixes the problem they can see, which is the parents' emotional distress," Chase said in a telephone interview from her San Francisco home. "It worsens the problem they can't see, which is the child's entire sexual future. "You know what they do," she fumes. "They measure the phallus -- a medical word that refers to penises and clitorises and everything in between. If it's longer than 2.5 cm, you get to keep it and be a boy. If it's shorter than that, they cut it off and call it a girl."
<<<

Yeah, get a ruler and a scalpel... Sorry, son... You didn't make the cut...

Mr. Dove writes:
>>>
I realize that many people do not support intervention to fix birth
defects or other medical conditions (e.g. Christian Scientists).  As a
biomedical researcher, I obviously disagree with this philosophy.  The
idea of blaming the social effects of birth defects on "a biased society"
is novel, but I'm afraid I don't buy that, either.
<<<

You don't need to. You need to let people speak and choose for themselves and not think of difference as "abnormality" or "defect."

One intersex person wrote a fantastic piece I'll conclude with:
>>>
I am intersex
by Lee

i was not born male
i was not born female
my mother screamed
the doctor rubbed his hands with glee
my father spat with disgust
the doctor rubbed his hands with glee
interesting, he mused, interesting
he looked at my penis
interesting, he mused, interesting
he looked at my vagina
an interesting medical problem
what do we do said my mother
trust me said the doctor
what we have here is yes
he poked and he prodded
what we have here is a
he tested and studied
boy, simply a boy with a problem
a very, very interesting problem
don't worry, just trust me
he picked up the scalpel
i know what to do
he stole my vagina from me
don't worry, i'm the expert
he stole my breasts from me
i'll just fix nature's mistake
he stole myself from me
i was not born male
i was not born female
i was made, created male
made to fit into your world
your limited, two-gender world
your frightened, unnatural world
i am your shame
so you make me feel ashamed
i am your fear
so you make me feel afraid
i am your hidden self
so you make me need to hide
i am the mystery you hate
so you make me hate myself
i was not male
so you said i had a problem
i was not female
so you said i had a problem
you stole myself from me
you are my problem
your small two-gendered world
you are my only problem
i am your other
i am not male
i am your other
i am not female
i am your other
i am intersex
i am hermaphrodite
i am your other
and i celebrate
<<<

I think that sums it up.

Pat Gehrke
CSU Chico
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