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For the Beginner Amelie Schreiber. What Intersex is Not. It is not “Hermaphroditism,” as this is a complete set of female and male reproductive organs, which is impossible in humans.
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What Intersex is Not • It is not “Hermaphroditism,” as this is a complete set of female and male reproductive organs, which is impossible in humans. • It is not “transgender” or “transsexual,” as gender identity and sex are not the same things, just like gender identity and sexual orientation are not the same. • It is not a disease or health problem, nor does it cause diseases or health problems.
What is Intersex? • Intersex is a natural variation in human sexual development which can be expressed in many ways such as hormonal variations, chromosome variations, genetic variations, and anatomical variations. • There is no one particular “intersex condition” and every intersex person’s body is different. • “Intersex” is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male. For example, a person might be born appearing to be female on the outside, but having mostly male-typical anatomy on the inside. Or a person may be born with genitals that seem to be in-between the usual male and female types—for example, a girl may be born with a noticeably large clitoris, or lacking a vaginal opening, or a boy may be born with a notably small penis, or with a scrotum that is divided so that it has formed more like labia. Or a person may be born with mosaic genetics, so that some of her cells have XX chromosomes and some of them have XY. (Intersex Society of North America)
INTERSEX refers to people born with chromosomes, genitals, and/or gonads that do not fit typical definitions of male or female. The most thorough existing research found intersex births to constitute 1.9% of the population.* However, given that only some intersex clinical patients’ records are used as data, the figure is likely to be substantially higher. • Intersex traits include variations of the reproductive organs such as the testicles, penis, vulva, clitoris, ovaries, chromosomes, and hormone levels, all of which which can result in additional variations in secondary sexual characteristics such as muscle mass, hair distribution, breast development, hip to waist ratio and stature. • Intersex is not a single category – many forms of intersex exist. Within each form, there may be substantial variation as well. • Intersex is not about gender identity: intersex people experience the same range of gender identities as non-intersex people. Intersex status is also not about sexual orientation: an intersex person may be heterosexual, homosexual, bisexual or queer. • * Fausto-Sterling, Anne (2000). Sexing the Body: Gender Politics and the Construction of Sexuality. New York: Basic Books. ISBN0-465-07713-7.
“Female” and “Male” Anatomy • XX Chromosomes • Ovaries • Clitoris • Labia • Vagina/Uterus/Fallopian Tubes • XY Chromosomes • Testes • Penis • Scrotum • Epididymis/Seminal Vesicles/Vas Deferens
Some Examples of Intersex Conditions and Prevalence • Not XX and not X, one in 1,666 births • Klinefelter (XXY), one in 1,000 births • Androgen insensitivity syndrome, one in 13,000 births • Partial androgen insensitivity syndrome, one in 130,000 births • Classical congenital adrenal hyperplasia, one in 13,000 births • Late onset adrenal hyperplasia, one in 66 individuals • Vaginal agenesis, one in 6,000 births • Ovotestes, one in 83,000 births, no estimate • Idiopathic (no discernable medical cause), one in 110,000 births • Iatrogenic (caused by medical treatment, for instance progestin administered to pregnant mother),no estimate • 5 alpha reductase deficiency, no estimate • Mixed gonadal dysgenesis, no estimate • Complete gonadal dysgenesis, one in 150,000 births • Hypospadias (urethral opening in perineum or along penile shaft), one in 2,000 births • Hypospadias (urethral opening between corona and tip of glans penis), one in 770 births • Total number of people whose bodies differ from standard male or female, one in 100 births
Ten Common Misconceptions • By Curtis E. Hinkle, Founder, Organisation Intersex International • And Hida Viloria, Human Rights Spokesperson, Organisation Intersex International
1. Intersex means that a person has both sets of genitalia. (False) • This is probably one of the most common misconceptions about intersex. Intersex often has nothing to do with the genitalia of the person, much less having two sets. There are intersex people with a penis and a vaginal opening. However, there are no documented cases of a person being born with fully developed male and female genitalia. The vast majority of intersex people have genitalia that look pretty typically male or female with a small minority having atypical genitalia. In fact, the quaint, pseudoscientific term‚ “true hermaphrodite” (which refers someone with ovarian and testicular tissue), can refer to a person with totally typical male or female genitalia.
2. 1 in 2000 infants is born intersex. (False) • This is one of the most common statistics given. It would be more accurate to state simply that in hospitals with gender assignment teams, 1 in 2000 infants is born with genitalia that are so atypical that the attending physician requests the help of the specialists in the team to assign a sex. Most hospitals in the world have no gender assignment teams and most intersex people have typical genitalia. One should be careful to note that even in the majority of births with atypical genitalia, the doctor does not request any assistance from a gender assignment team even if one is available. Therefore, one can readily see that this figure gives the impression that intersex is very, very rare. It isn’t!There are so many different intersex conditions that it is very hard to give a statistic at this time. A more accurate estimate is given by Sharon Preves, Ph.D., author of Intersex and Identity: The Contested Self, who has researched the topic of intersex very thoroughly. According to Preves, “The frequency could be as high as four percent.”
3. When an intersex child is born, they cannot be left to grow up as is, but rather “something must be done.” (False) • There are very few instances when a child’s intersex variation poses health risks that require immediate medical attention. Rather, intersex people, like all people, have health issues. For example, being a female is not in and of itself a health problem but there are health problems specific to females. In the majority of cases where there are no health risks involved, we have witnessed that it is more beneficial to the intersex child to be allowed to grow up with their body intact. Preserving their bodies’ integrity allows intersex children to develop their own sense of sex and gender identity without the risk of irreparable damage to the formation of this identity. The child can be raised with a provisional sex assignment of male or female and left to decide for themselves, as all other humans are given the right to do, if this sex feels right for them later on, and/or if they wish to make any cosmetic changes to their body to align it with their sense of self. Attempting to make these decisions for infants and children, while perhaps well intentioned, is playing a game of speculation with another person’s life.
4. Intersex is about homosexuality. (False) • The underlying reasons for pathologizing intersexuality and suggesting treatments which are often barbaric are most likely a result of homophobia. However, there is nothing about intersexuality per se that would cause one to state that intersexuality and homosexuality are the same issue or that they are directly related. There quite possibly are links but the physiological reasons are not fully understood at this time. What is important to understand is that many people with intersex conditions, just as those without them, sometimes identify as gay or lesbian. Similarly, many intersex adults find the issue of homosexuality irrelevant to our perception of ourselves. More and more intersex people are comfortable with an intersex gender identity which we feel is more accurate in describing how we perceive ourselves. • The socially constructed model of eroticism offered up by many cultures which divides people into homosexual and heterosexual erases our existence. Even bisexuality further perpetuates the idea of only two genders by the use of the prefix “bi‚” which means‚ “both.” There are people who are primarily attracted to androgynous people, to “masculine ” women or “feminine” men. And most important of all, what is the opposite sex of an intersex person?
5. Disorders of Sex Development, or DSD, is the preferred term for intersex. (False) • All members of the Organisation Intersex International (OII), the largest intersex organization in the world, reject the label Disorders of Sex Development (or DSD) for the simple reason that we are not disordered, but different, and we refuse to accept medical language and views which pathologize us. The fact that some intersex individuals choose to use this term to describe themselves, just as some homosexuals view their homosexuality as a disease to be cured, does not discount the fact that the label is inaccurate and stigmatizing to the community as a whole.
6. Intersex is not about gender. (False) • To many intersex people, gender is the main issue. In many countries around the world, there are no early surgeries to “treat” intersex bodies. These people’s main issues are often based on not being able to fit into either gender or growing up with a body incompatible with the gender in which they were raised.The very theories used to support mutilating intersex bodies both surgically and hormonally are based on notions of gender which have been proved to be unreliable. According to the theories often espoused by followers of Dr. John Money, gender is not innate to the individual. We have no proof of this. We do have quite a bit of proof to the contrary. Intersex is not just about our bodies but also about how we perceive ourselves within those bodies and gender identity is a crucial part of everyone’s identity. To erase the importance of gender to the individual intersex person is to reduce that person to only the physical aspects of their body, neglecting the more important part of the equation, their own perception of that body and themselves, as opposed to how others perceive them.
7. Intersex is part of the transgender movement. (False) • No. Whereas individuals who are intersexed might identify as transgender, the opposite is not true. Most people who are part of the transgender movement are not intersexed. To include intersex under the umbrella term ‚ “transgender,” overlooks our specific needs which often are medical reform, legal issues concerning which gender we are, health issues specific to intersexed bodies and more importantly, the fact that most intersexed people are not trans. Many are perfectly happy with being men or women and more and more of us are quite happy being intergender and find the notion of trans totally foreign to our identity because we are rejecting binary gender altogether and the prefix‚ “trans,” just like the prefix “bi‚” mentioned earlier, keeps the binary well intact.
8. The intersex movement is an identity movement like other GLBT movements. (False) • Not exactly. The Organisation Intersex International campaigns for full Human Rights for all people born with intersex variations, some of whom do not claim “intersex” as an identity. Our diverse community includes people who identify as intersex males, intersex females, intersex, males, females, or sometimes, also, transgender.
9. Most intersex people were assigned female. (False) • Many intersex conditions in infants assigned male are often overlooked and the parents are simply told there is some work necessary for proper urination or that a testicle has not descended, etc. In addition, in many parts of the world intersex people are assigned male if at all possible because it is deemed more socially desirable to be male. When one reads about all the various intersex conditions, one realizes that a person born with an intersex condition is just as likely to be assigned male as female.
10. Intersexuality is a condition which can be cured. (False) • Surgical “normalization” of intersex bodies is an attempt, like eugenics, to remove differences which some people have decided are undesirable, and it often creates problems which were previously non-existent. To view intersex variations as conditions which can be cured justifies the barbaric medical practices we are often subjected to, such as genital surgeries and/or hormones which may be contrary to our own core identity, and psychological treatments for not wishing to comply.
Surgical and Hormonal “Treatments” are Relatively New, Oppression is Not • Judaism and Intersex people • Roman persecution due to fear of intersex people as an indicator of terrible events to come • Voting Rights • Olympic Competitors (ex. Caster Semanya, Maria Patiño), and the evolution of “gender testing”
Surgery on Intersex People • The typical course of action for intersex children is to try and “normalize” their body through surgery and hormones. • Surgery is detrimental and harmful to the intersex person’s body. • Surgery is non-consensual and an assault on a child’s body. • It removes healthy, functional genital and reproductive tissue and leaves scars behind. • It does not improve “functionality,” it in fact reduces it. • It causes psychological and physical trauma that is irreversible. • It is often done secretively without the parents knowledge, or parents are coerced into it.
Hormonal “Treatments” • Hormonal treatments are also harmful to intersex children. • They change the anatomy and physiology of the person and sometimes these changes are irreversible. • They are non-consensual and are often done to manipulate a child’s body in order to make surgery easier or to mold their body to fit into a sex binary.
David Reimer a.k.a. the “John/Joan Case” • David Reimer’s Parents Instructed to have “sex reassignment surgery” on David by John Money • Money’s theory was that “sex identity” was malleable and David should be raised as a girl • Money was sexually abusive to David, his twin brother, and other child patients who were “gender or sex nonconforming” • Milton Diamond apposed Money’s theory, but therapists working with David after he rejected his sex and gender assignment were too afraid to come forward or dispute Money’s theories and opinions for fear of career assassination or retaliation by Money, who was very prominent and powerful in the mental health and medical communities. • Psychiatrists apposed to Money, working with David after his years with Money were too afraid to appose money in the open for fear of retaliation. One doctor stated to Diamond that he, “was shit scared of Money... I didn’t know what he’d do to my career.” Years went by before Diamond gained support and was able to get David’s story out.
Modern Surgery and Doctors’ Obsession with Altering Children’s Genitals
Resources and Info • http://oiiusa.org/ • http://intersexroadshow.blogspot.com/