“Is it a boy or a girl?” The first question uttered when a baby is born and sometimes even beforehand. What if you are neither entirely a girl nor a boy? The biological male-female binary divide is so engrained in our society that the idea of any ambiguity has been hidden from view to the point that many people do not know that it even exists.
Intersex is an umbrella term used when a person is born with reproductive or sexual anatomy that does not fit into the typically distinct categories of male or female. It encompasses over thirty different conditions that originate prenatally, in which a person’s biological sex may be in between that of male or female, or it may appear to be male but is internally female (and vice versa). Approximately one in two thousand people are intersex, which translates into about 3 million people in the world.
I am ashamed to admit that I thought that biological sex was completely binary until two weeks ago when I was fortunate enough to see a screening of the documentary ‘Intersexion’ by the Gender & Law at Durham (GLAD) Research Group. My lack of knowledge of the existence of intersex people illustrated to me the hidden and unknown nature of this phenomenon in our society. Intersexion eloquently captures the diverse experiences of many intersex individuals. Moreover, the documentary highlighted that the rigidity of understandings of sex and the degrading and intrusive treatment for those who do not fit distinctly into one category can have severe detrimental impact on the formation of one’s own identity. In this documentary, Mani Bruce Mitchell interviews intersex people from New Zealand, Australia, South Africa, Ireland, Germany, and the United States of America in an attempt to explore why this concept is so unknown and to shed light on the similarities and differences of growing up as intersex in a clearly binary world.
Dr John Money and Intersex Surgery
In Intersexion, Mani explores the power that Dr. John Money, a sexologist at Johns Hopkins University in the USA, has had on the treatment model for intersex babies through his theory of gender. Dr Money’s theory provided that gender is primarily determined by nurture rather than nature – that if a child was raised as male or female they could end up being a straight boy or girl with no gender issues or sexual orientation differences. Dr. Money’s most famous case was David Reimer, an identical non-intersex twin boy whose circumcision resulted in the burning off of almost his entire penis. On Dr Money’s recommendation, David was reassigned as female and underwent surgical, hormonal, and psychological treatments. Dr. Money used David, known as Brenda, as evidence for his theory that gender identity is about the upbringing of a child rather than biology. However, Brenda was not happy as female, and once he found out of the history of his reassignment, David reassumed a male identity, before later committing suicide. David Reimer was not in fact evidence of Money’s theory yet Dr. Money continued to use the case as proof of his theory.
Unfortunately, Dr. Money’s theory has had a strong influence on the treatment of intersex people: the surgery, the hormones, the gender reassignment, and the secrecy which has surrounded the lives of intersex people. The medical profession, who are trusted and believed by nervous and frightened parents, have a lot of power to influence decisions to undertake ‘corrective’ surgery on intersex children. Many parents just want their child to be ‘normal’ and believe that surgery can achieve that. In Intersexion, Tiger Devore from Brooklyn, USA argued that once you have genital surgery, you are a patient for life. He was born with open genitals and had to have more than a dozen surgeries before the age of ten. During this time, his questions would be responded to with the phrase ‘everything’s fine’. In the summer he would spend six to ten weeks in the hospital during which time everyone was told that he was on vacation. Other intersex people have endured hundreds of genital examinations which they never wanted. Jen Paconis had surgery on her clitoris at three years old because it was too big by their standards for a ‘normal girl’. They claimed they were going to preserve the function and feeling of it, but in reality she says that it seemed to be more about appearance, regardless of the fact that it is not a part of the body that is seen on a daily basis! Many intersex people grow up with no obvious differences in their body until they reach puberty. At that stage, some feel the need to have surgery thinking that they will not be wanted and loved and view it as a ‘quick fix’.
To have your most private organs mutilated at such a young age is likely to result in feelings of disgust to your own body. In addition, there often seems to be a lack of sensitivity in the process, especially when many medical students are brought in to look at a ‘rare case’ and when your genitals are being prodded at routinely, which is degrading and undignified. The fact that Mani was unable to find anyone who went through this surgery and endorses it illustrates that the interventionist approach is not positive for those whose lives are affected. Even though it has now acknowledged that the treatment under Dr. Money’s theory is wrong, hospital treatment has been extremely slow to develop. There continues to be approximately five non-consensual intersex surgeries per day on intersex children.
Secrecy and Shame
Intersexion also presents intersex people who have not undergone surgery. Hida Viloria from San Francisco never had any treatment, but was told later in life that her clitoris was not ‘normal’, emphasizing the seeming need for one’s genitals to fit into a certain criteria of appearance. This was also illustrated by Jim Costich, from upstate New York, who avoided surgery but was sent to a new gender clinic when he was a teenager where they announced to him that they had assigned him the wrong sex. At fourteen years old he was told that he was neither male nor female, that that was all that there was in the world, and that, therefore, he was nothing.
These approaches to making biological ambiguity invisible have resulted in secrecy and shame. Intersex people have been trained to be ashamed of their differences and to hide them. Bo Laurent, from California, was thought to be a boy at birth. At one and a half years old her parents were told that she was in fact a girl and were instructed to change her name, move to a different place, and not tell anyone. Her parents threw away all her baby pictures and never spoke about it. Michel Reiter from Germany had a similar experience. Michel was born with a penis but reassigned to female two weeks after birth as his chromosomes were female. He was surgically transformed from male to female at age one. His parents moved and spent much of their time isolated in the mountains far from the judgments of society. Secrecy not only creates confusion for intersex people when bits of information are revealed throughout their life, but also a lack of trust in parents who should ideally be a source of support for children. Due to their vulnerability, intersex people are also often subjects of abuse.
However, the anonymity and the vast amount of information on the internet has provided a valuable resource to connect people, to realise that they are not alone in their experiences, and to reach out for support.
Despite the differences in treatment and experiences of being intersex, there seemed in the documentary to be a common belief that everyone should have a choice as to what is done with their body and how they want to identify. Parents should not be allowed to decide on what surgery will be done to their child’s body at a very young age. They should instead have support from other parents who have gone through the same experience and to meet another adult that is intersex. This would allow all parties to have the support and education needed to make proper and informed choices when the need arises.
Recently, Germany has changed their law to allow parents to leave the ‘sex’ box blank on the birth registration form, effectively creating a new category of ‘indeterminate sex’. This will allow parents to make more informed decisions regarding sex assignment surgeries, rather than the previous rushed decisions that have often produced negative results for individuals. German passports will also have an additional category for intersex holders. Although this is clearly a development in the public recognition of intersex people and has power for the reason alone that it breaks the barrier of secrecy, it has been criticised by LGBT groups, such as ILGA-Europe, for not addressing the issues of surgery and “medicalization of intersex people”.
We fear difference and hence we try to fix or hide anything that is different from what is ‘normal’. This intolerance of difference has and continues to allow for the degrading treatment of many groups of society that do not fit into our distinct categories. We must realise the effects of this intolerance on the lives of individuals. As Jim Costich says, “being different is not horrific”. At the end of the day, no matter our differences we are all people, we are all inherently human.