Doc Reverses Intersex Advice

Doc Reverses Intersex Advice

by Andrew Davis
Windy City Media
2005-03-02

In a move that some have hailed as groundbreaking, researchers told
physicians at a Feb. 18 meeting of the American Association for the
Advancement of Science to postpone surgery for intersex children until they
determine their own sex.

Dr. William Reiner of the Oklahoma University Health Science Center
told the gathering that “ [ t ] o discover who or what a child is ... you
have to ask [ that person ] ,” , according to an Associated Press
report.

Reiner, who once performed sex-reassignment surgery on babies as a
urologist, said that doctors once thought that external reproductive organs
were enough to determine gender. However, he began seeing children who
were assigned to one gender as babies but identified themselves with
the other as they grew older. Reiner then became a psychiatrist to study
these children. His latest review of children found that over half of
the genetic males crossed over to become boys even though they were
raised as girls —with some starting the transition as early as 4-1/2 years
old. These results have led Reiner to advise parents to wait before
agreeing to surgery for an intersex baby; he feels that there is no need
for an intersex individual to go through the agony of irreversible
surgery in addition to social trauma.

Dr. Eric Vilain of the University of California-Los Angeles echoed
Reiner’s thoughts at the conference. Vilain identified 54 genes that work
different in male and female mouse embryo brains just a few days after
conception—and before sex hormones are ever made, underscoring that
gender can be independent of genitalia.

“Intersex” is a term that describes approximately one in 4,000 babies
born with male and female characteristics. One of the most common
combinations is called congenital adrenal hyperplasia. While in the womb,
genetic girls with XX chromosomes are exposed to such high levels of
androgen ( the hormone responsible for male development ) that they appear
male externally while possessing female reproductive organs.

Reactions to the researchers’ recommendation has generally been
positive from the intersex community. Lynnell Long, a local activist, told
Windy City Times that she feels “really good that doctors have finally
started to listen to intersex activists and older individuals who wish
that people had waited for surgery. It was great for Dr. Reiner to [ air ]
his opinions where they can be widely viewed.” Long added that parents
probably will listen because physicians can make more of an impression
saying the same thing that an intersex advocate urges: “For some
reason, parents tend to think that doctors are God so they listen to them
more than they would to someone who been in the same position.”

Riki Wilchins, founder and executive director of Gender Public Advocacy
Coalition, also praised Reiner’s advice. “I think that there has been
this growing awareness in the medical profession for some time that the
treatment protocols for intersex children were seriously out of joint,
hyper-aggressive, and intersex-phobic. This announcement is an
acknowledgment of that—and it’s long overdue,” Wilchins told Windy City Times.
“Doctors are recognizing that [ intersexuality ] is not a medical
emergency; they now feel that they should see what gender the child is and,
if possible, let the child participate in decisions regarding surgery.”
As for what to advise the parent of an intersex baby, Wilchins simply
recommends “loving your child and not taking any unnecessary and
irreversible medical steps.”

Cheryl Chase, executive director of the Intersex Society of North
America ( ISNA ) , agreed that the doctors’ recommendation was good but felt
that key elements were omitted. “The AP article completely missed the
legal aspect,” Chase remarked to Windy City Times. ( Indeed, ISNA’s Web
site mentions several legal issues, such as individuals being denied
civil rights because they do not fit into a particular gender. ) “Also,
the article said that surgery shouldn’t be done because the child may
not turn out to be the sex that you pick. That’s true, but what’s really
important is ... the child may turn out to be really unhappy—even if
you get the sex right. A lot of these surgeries are performed on girls
who grow up to be women who are upset that someone removed parts of their
clitoris and rearranged parts of their vaginas. That is definitely
harmful.”

Copyright © 2005 Windy City Media Group. All rights reserved.