Re: sex, not gender {actually, it IS Gender}

FWIW.

Do note the implicit assumption of a biological normality as the
ground of possibility for much of the description... Is it possible
to quarrel with that? Or isn't that the basis upon which one makes
one's visits to the clinic?

The implicit sociology of the piece is a somewhat different matter...

Still, if one has children, one better be prepared to deal with
menstruation and wet dreams. Wouldn't do to shove them under the
carpet in this day and age. And if the boy doesn't have testes, best
go to the clinic; wouldn't be doing him/her any favours by saying,
"hey, you got a unique set of genitalia", and leaving it at that...

Khoo KJ


http://www.exn.ca/html/templates/sexfiles-story.cfm?ID=19991208-53

Intersex: When you're born not really a girl or a boy

 In the mid-seventies in the Dominican Republic, 18 young 'boys' all
born around the same time were being raised...well, as girls. At
birth, these children had had female genitalia. Then puberty hit.

The girls' voices deepened, mustaches developed, their 'clitoris'
grew into a penis, and their testicles descended. They started
exhibiting sexual interest in women. The 'girls' became 'boys'.

The children, in a rare genetic anomaly, had all been born with a
type of male pseudohermaphroditism, also called DHT deficiency
syndrome. They were all genetically male - however they lacked a
vital enzyme that converts testosterone into dihydrotestosterone, or
DHT for short. Testosterone by itself can only do part of the gender
job. The development of a penis is dependent on DHT. People without
DHT are born with female genitalia.

When puberty started, the testosterone from the testicles hidden in
the childrens' abdomens acted on the brain. Somehow their body
finished the gender job - just a little late. According to
anthropologists, the villagers in this macho culture rejoiced when
they found out they had a son rather than a daughter. The villagers
made up a new word to label these children. It was 'guevedoces' which
means 'penis at twelve'.

In the end, sixteen of the 'boys' switched to a male gender role. One
chose to become sexually male but remained in a female work role. A
third chose the gender identity and work role of a woman.

The word in North America for these 'guevodoces' children is intersex.

People with ambiguous genitalia used to be called hermaphrodites. But
now, according to Cheryl Chase, director of the Intersex Society of
North America (ISNA), "Calling someone a hermaphrodite is
stigmatizing and sensationalizes things." The current term is
intersex, and this term covers a variety of medical conditions that
result in genitalia that is neither clearly male nor female. "There
are at least three dozen medical diagnosis that result in a child
being born with an intersex anatomy and they are all different," says
Chase. "Some people have a biology that will make them develop in a
masculine direction, some will develop in a feminine direction, and
some will develop both masculine and feminine characteristics at the
same time if there isn't any medical intervention."

Medical terminology, however, still uses the term 'hermaphroditism'.
There are types of 'true' hermaphroditism where even on a genetic
level it is impossible to determine whether the person has XX
(female) or XY (male) gender.

An egg and a sperm fuse to form a zygote. In a condition known as
'chimerism', two zygotes, one XX, and one XY, fuse in the womb to
produce one person who will have some XX cells and some XY cells.
"People believe that women have XX and men have XY and that's all
there is, but it just isn't true, the world doesn't work that way,"
says Chase. For example, in the last Olympics, athletes were
genetically tested to make sure that their gender really was whatever
the athlete declared it to be. Some competitors were disqualified on
the basis of this test. "None of them were men: all of them were
women with unusual chromosomes," says Chase. In other words, all the
disqualified women had cells that were other than XX.

Most 'true' hermaphrodites are XX, yet they possess 'ovotestes' - in
other words, reproductive organs that have some testicular tissue and
some ovarian tissue.

Another intersex condition is called androgen insensitivity syndrome,
or AIS. It's an example of a condition where the person is
genetically male but almost always ends up in a female gender role.
It's passed genetically along the female bloodline.

The AIS person's sex chromosome is XY, or male, and they possess
testicles, though these remain in the abdomen. However, the body
lacks the receptors necessary to 'read' the instructions of the
masculizing hormone androgen. "AIS occurs in a spectrum of levels,"
explains Chase. "So if you have complete AIS, your body is incapable
of responding to testosterone. A person like that who has XY
chromosomes will be born with female genitals but no uterus or
ovaries. There will be testes inside. She will be labeled a girl and
grow up to be a woman but not exactly like other women. She hasn't
got a vagina, or her vagina is very short. She can't menstruate, and
she has no pubic or underarm hair, or acne. Her genitals and nipples
will appear somewhat immature."

AIS individuals are 'women' and many do not discover their condition
until they fail to menstruate at puberty. Their testicles are often
removed because there is a risk of cancer. These women are infertile;
however, they sometimes develop super-model type tall, hairless
bodies that are truer to the beauty myth than 'real' women.

The term intersex, then, covers the whole terrain from chimerism to
AIS women whose bodies cannot 'read' the masculinizing messages of
androgen. It's also used for the one in 100,000 people who are born
with an ovary on one side and a testicle on the other. Intersex also
covers those men who have hypospadias. In other words, their urinus
meatus or 'peehole' is not located on the tip of their penis. It can
be on the side of their penis or at the base of their penis.

Intersex is a word that includes the people we don't think of when we
think 'hermaphrodite'. "If you are talking about somebody who had a
clitoris larger than three eighths of an inch when she was born, to
say that person is a hermaphrodite, gives a very unusual impression,"
says Chase. Yet you can call that person intersex. And the large
clitoris scenario is exactly what happened to Cheryl Chase herself as
a child.

Cheryl was born Charlie in the 1950's and raised as a boy. Chase
writes about her experience in Alice Domurat Dreger's book,
Hermaphrodites:

"It took months for me to obtain...my medical records. I learned I
had been born, not with a penis, but with intersexual organs: a
typical vagina and outer labia, female urethra, and a very large
clitoris. Mind you, 'large' and 'small' as applied to intersexual
genitals, are judgements that exist only in the mind of the beholder.
>From my birth until surgery, my parents and doctors considered my
penis to be monstrously small, as well as lacking a urethra...Then,
in the moment that the intersex specialists announced my 'true sex'
was female, my clitoris was suddenly large."

Charlie underwent an operation to remove this intersex organ that
could be seen as either a large clitoris or a small penis. Her name
was changed to Cheryl. The doctors told her parents to get rid of all
reminders of her boyhood, and to not say anything about it.

"Sex reassignment... is really done in a very authoritarian way by
doctors," says Chase. "Doctors are fairly conservative. They are not
at the center of any sort of literary or cultural studies that are
really looking at gender in a new way... Most medical practitioners
who are working with intersex babies refuse to talk to intersex
adults. Or acknowledge that the experience of an intersex person's
life is relevant when they are making a decision about an intersex
baby."

Chase's organization was recently involved in assisting the parents
of an eight-year-old intersex child. "He was born with a very small
penis and his doctors said, 'well this child is a girl and should be
raised as a girl'," says Chase. "The doctors said 'don't worry, we
will do a little surgery and everything will turn out fine. You'll
have to give her estrogen when she's a teenager and she won't be
fertile but she will be a girl and you'll be really happy'. The kid
gets to be eight and is clearly acting like a boy - not like any girl
anyone's ever seen." At this point the child's parents contacted
Chase's organization, and talk to some of the doctors and a
psychiatrist who work with the ISNA.

"Then we introduced the parents to a person who works with us named
Max who had the same thing done to him. Max was born with a small
penis and doctors decided to cut it off and make him a girl, and he
lived extremely uncomfortably as a girl and as a woman until he was
in his mid-thirties," recalls Chase. "He is now taking testosterone
and has had a mastectomy to remove the breasts that were grown on his
body as a result of doctors giving him estrogen. He's marrying the
woman he was living with. So we were able to introduce him to the
parents of this child, so they were able to have somebody tell them
what it might be like to grow up like their child is growing up."

After getting this information, the parents told their child exactly
what had happened to him. "The same day he announced that he was
going to change his name and live as a boy," says Chase.

The ISNA is dedicated to helping intersex people. "A lot of time our
organization is viewed as one against surgery, and that we promote a
third sex," says Chase. "And neither of those things are true, what
we are saying is that intersex people should not be treated as though
they are shameful. And they should be allowed to choose medical
technology to improve their lives."

She understands, although she doesn't agree with, the early gender
assignments done by doctors. "Doctors don't believe that they are
doing this in order to hurt people. They think that it would be
unthinkable to grow up with unusual genitals. They think grandma
would scream when she opened the diaper. If you were a boy and you
couldn't pee in the snow as far as other boys they would ostracize
you. If you were a girl with a prominent clitoris they would
ostracize you. And nobody would ever want to have sex with you and
you would grow up absolutely despondent and you would want to commit
suicide."

It comes down to waiting for an intersex baby to grow up and make his
or her own choice. "We are saying that doctors should not cut off any
parts of clitorises that are large in infants," says Chase. "But if
an adult woman is uncomfortable with the size of her clitoris she
should have the surgery done."