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s o ç im o f N o m H A merica
Hermaphrodites
' V
The historic 1996 action in Boston included a large turnout of members from the Transsexual Menace, who provided a model of protest actions for the Intersex Society. Max Beck (right photo)
is an intersex activist from Atlanta.
use of sex reassignment surgery, and the case of
Reiiner continues to act as proof of success
despite the fact that he reverted to his original
genetic identity of male.
Conservative estimates, based on studies at
Brown University and elsewhere, indicate
that 1 in 2,000 hahies, or five a day, is horn
intersexed in the United States. Yet data on
how many have suffered as Reimer did have
been difficult to gather. The silence around
this issue, both from the medical establish
ment and in the families affected, has been
deafening until recently.
Another statistic: 9 out of 10 of these surg
eries are clitorectomies. A quote from a Har
vard doctor is often cited in this context: “ Its
easier to dig a hole than to build a pole.”
describes what must he done about the condi
tion once it becomes apparent. His choice of
words is telling. “The finding of ambiguous
genitalia in a newborn is a medical and social
emergency. When the cause is established and
gender assignment is made, the abnormal geni
talia must he corrected."
Advocates increasingly question why this
is such an emergency. Medically speaking,
radical surgery is not necessary unless there
is an underlying pathology, which is fre
quently not the case. Socially speaking is
another matter.
“ Many doctors believe (surgery] will make
the parents’ distress end and will prevent the
child from feeling any distress,” ISN A board
member Alice Dreger says. “ In fact, these
surgeries carry great risks, including risks to
TH E M E D IC A L E S T A B L IS H M E N T
genital sensation, which the child will need
later for a healthy sex life; continence; fertil
t the Creating Change conference
ity; and life.”
last Novem ber in Portland, the New
Koyama talks about the difficulty of deal
ing with doctors, who tend to dismiss the
Jersey-based intersex advocacy or
ganization Bodies Like Ours presented a
concerns of intersex activists, even those
forum on this complex issue. According to
who can personally attest to the failure of
outreach director and co-founder Betsy Dri
these surgeries and the
ver, parents are kept in the dark about the
long-term conse-
entire process and may in fact he frequently I quences that are
misled to think that “there are no people
essentially irreversible.
who survived like her.”
She notes a typical
They arc simply told that in the case of
doctor’s reaction: “You
boys with micropenises, for example, ‘.‘This
say you have problems
child is better off being raised female.” The
with your sexual sen
medical motto, according to Driver, seems to
sation because of
he “Do it, do it early, and don’t discuss it."
surgery, hut 30 percent
Tlie activist, who described an array of
of women are not
emotional and physical problems that have
orgasmic anyway, so
how do you know it’s
plagued her since her surgery, asserts, “Surgeries
rob children of the quality of life and the right
because we chopped
off your clitoris?”
to bodily integrity.” She spoke about the
strange “desperation” by the medical establish
For Koyama and
ment to “make it right" regardless of the cost
others, the whole process has the aura of ritual
on the individual child.
abuse. These operations are “something done
Koyama, who taught the first course in
by adults who are supposed to he trusted, per
intersex studies at Portland State University,
ceived as normal,” she says. “There is so much
agrees. “They don’t want queer HxJies.”
secrecy and silence going on that the children
Getting rid of these troubling “queer hxxl-
grow up feeling the secrecy and isolation. You
ies" has for decades been the province of doc
can’t tell anyfxxJy about it. Children learn that
tors. One of the tools used by advocacy groups
there’s something horribly wrong with them
such as the Intersex Society of North America
and their sexuality”— a concept reinforced by
and fkxlics Like Ours is a standard medical
the frequent genital scarring and a pervasive
training video in which a d(x:tor calmly
feeling of disconnect between the body and the
mind that makes the much-touted goal of a
“normal life” elusive.
“Society doesn’t want deviation in general,’
Koyama continues. “Physical differences are
corrected without consent, even if it doesn’t
help the child’s quality of life." The goal of the
ISNA and other activist organizations is to
change the protocol.
The medical establishment’s reaction—
with some recent exceptions— is typified in
comments like that of Dr. Aydin Arici, an
obstetrician and gynecologist at Yale-New
Haven Hospital, who performs such surgeries:
“It is irrelevant if the sex assignment is male
or female, as long as there is an early sex
assignment, and the parents understand what
they have: either a boy or a girl.” Nurture
trumps nature.
TH E IS N A
L
eading the charge against unwilling sex-
reassignment operations are those most
viscerally affected by them: the now-
grown children who have been subjected to
genital surgeries for
decades. Wresting
power from an often
hidebound medical
establishment is never
easy, hut groups like
A C T UP have shown
how effective grassnxus
organizing can he.
Children operated on
within the first two
years of life have
no way to judge
whether the procedure
makes sense and
no way to protest or
stop it if it doesn't
Hermaphnxlites
Speak! director Cheryl
Chase was horn a boy
hut surgically altered
to become a girl at 18
months when doctors
decided that her
micropenis was in fact an unnaturally large
clitoris and had to he removed. W hat fol
lowed were a troubled adolescence, a family
nearly destroyed by what she calls the “secre
cy and shame" and eventually a move to San
Francisco, ground zero for gender-bending.
There she found a vibrant, welcoming
queer and tranny community, as well as the
emotional and financial support necessary to
start ISN A , the world’s first advocacy group
for the intersexed, in 1993. This month the
group is moving its headquarters from north
ern California to Seattle.
“ I found others who had been treated in
ways very similar to myself,” Chase told
Curve magazine. “Everybody that I had met
had suffered in complete and total shame and
isolation and believed that they were the
only one.”
ISN A , she decided, would he organized
around ending that shame. The stated mis
sion: “to create a world free of secrecy, shame
and unwanted genital surgery for intersexed
people."
Koyama, who has worked with ISN A as
an activist-in-residence, notes the group’s
success in outreach to both the intersex
community (partially through a robust Web
site) and to the medical community, which
has been a tougher sell. “Before IS N A ,” she
says, “there was no organizing. Nobody was
making a political movement. Cheryl was
really persistent and really patient.”
The organization has been highly visible,
working through the media and at academic
and medical conferences to make more people
aware of the issue. This success has also
spawned other, more specialized groups. Bodies
Like Ours, for example, has shown particular
expertise in the medical issues surrounding
intersex.
“They do a really good job o f speaking to
the medical field,” affirms Koyama. “ It’s easy
to shout something at the medical comm u
nity, hut it’s really difficult to get them to
listen."
ISNA’s message has not been to stop all
surgeries, only medically unnecessary ones. The
organization supports a “patient-centered
model” rather than a “concealment-based
model.”
This preferred model calls intersex “a
problem o f stigma and trauma, not gender”
and emphasizes the need for professional
mental health care to handle the challenges
involved. Parental distress should not be
treated by surgery on the child. And “all
children should be assigned as boy or girl,
without early surgery.”
Som e of the complexity and controversy
surrounding intersex is evident from the last
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