Intersexuality: Who Makes the Call?

The term intersex isn't a common word in most people's vocabulary, nor is it something that many people are familiar with. In fact, most people aren't even aware that it can occur. Intersexuality is a term used to describe people who are born with both male and female characteristics, making it hard to determine which sex they actually are. Approximately 1 in every 2000 births results in the doctor questioning the child's gender, and there are many scenarios that fall under the category of intersex. Two of these scenarios include having both X and Y sex chromosomes or having male and female genitals. When it comes to having both genitals, it can mean a person can appear to be female, but actually have underdeveloped male genitals as well, and vice versa. In most cases, intersexuality will either be discovered at birth, or after puberty is reached and the person realizes that they are infertile. However, many actually go their entire lives without ever knowing they are an intersexual.

The thought of being an intersexual can be traumatizing for the person experiencing it, but what is a parent supposed to do if their child was in that situation? Are they the ones to make the decision on what gender their child is, or should that be left to the doctor or even the child themselves? In today's society, many doctors follow the Concealment-Centered Model when it comes to intersexuality, which means that the doctor will make the decision on which gender the patient will be, and then perform the surgery or treatment as soon as possible (Shifting the Paradigm of Intersex Treatment 1). Gender is designated by three scenarios:

1. If the patient has a Y chromosome and a penis can be constructed, they will be male

2. If the patient has a Y chromosome and a penis can't be constructed, they will be female

3. If the patient has no Y chromosome, they will also be female (Shifting the Paradigm of Intersex Treatment 1)

The reason why these surgeries are performed as soon as possible is because it will alleviate things such as depression and suicidal tendencies, as well as ridicule and the feeling of being different, which are all feelings the person might experience later on in life (Shifting the Paradigm of Intersex Treatment 1). But how would that person feel knowing that their life was determined by a doctor, without them having any say in it whatsoever? The doctor isn't the one who is living as an intersexual, so they shouldn't have any say in determining the sex of the child. This should be left solely to the child, based on whether they feel more like a boy or a girl.

According to Cheryl Chase, founder of the Intersex Society of North America, this decision should in fact be left entirely up to the child, but only after they reach puberty and are briefed about their condition (Graff 375). This is referred to as the Patient Centered Model, which directs all of the focus to what type of life the person wants for themselves. They will only undergo surgical procedures to become a male or a female if they request them, and understand the risks that are associated with such operations. The patient can also remain an intersexual, since there are no medical conditions associated with that lifestyle, aside from infertility and a different appearance than that of a typical male or female. However, if the patient does choose to remain an intersexual, they will be assigned a gender anyway based on certain tests, but they will not actually go through the steps to become just one gender.

It is said that an intersexual will experience negative things throughout their life since they are different, but this can be alleviated by having them construct their own life. Despite the fact that the child is both male and female, having a doctor or a parent determine that child's sex without their consent will lead to more complications later in life than the condition itself. This is different than say, a child being born with a deformity, such as an underdeveloped hand, and the parents making the decision to amputate it. That child will learn to overcome their disability, but how could one overcome the fact that their parents, or a doctor, determined their gender for them? That would be demoralizing, especially if that child felt as if they weren't that gender, and almost had to live a lie for the rest of their life. That type of situation would surely lead to depression, and in most cases, suicidal thoughts as well.

This can be related to the study that John Money did regarding sex reassignment at birth, without the child even knowing. When a child, referred to as John, was accidently castrated, Money decided that he was going to go through surgery in order to turn him into a female named Joan (Graff 375). At an early age, Joan started receiving doses of female hormones, and Money believed that his plan actually worked. He thought wrong. Despite looking and being treated as if he was a female, Joan always referred to herself as being a male. Now, despite never being told that she was born a male, somehow she still referred to herself as one. This is exactly why they should be the ones who control their own fate, since it will prevent things like this from happening.

Even though it is the moral thing to let the child determine which sex they would like to be later in life, it wouldn't be wrong for parents to assign their child a gender, without performing any surgical procedures at all. This can be done through a series of tests which will determine whether the child is likely to feel more male or female as they reach puberty. After the tests are analyzed, the child will be assigned the gender that doctors feel they will desire to be later on in life. Even though they are labeled as being a male or female, they really aren't a gender at all, which still leaves the possibility of change up to the child themselves. If they were predicted to be more masculine, but they turned out to view themselves as a female, they could still undergo the surgery to fulfill that, since their gender was never changed in the first place. This process is just a way of getting rid of that "third gender" perception, since it is not an actual gender in today's society, and therefore, wouldn't be accepted by many.

But what if a child didn't want to be viewed as a male or a female, but rather just an intersexual? This is realistically what they are, and some might not want to change that. Although doctors state that it is best to perform sex reassignment surgery as early as possible because it will prevent emotional problems from occurring, studies actually show that people living as an intersexual don't experience any more psychological illnesses or social ridicule than someone who is just a male or female. In fact, people who are born as an intersexual actually have lower rates of mental illnesses than the rest of the population, which completely contradicts the views that doctors have. In reality, an intersexual is a person just like the rest of us, so they should be able to do what is going to make them happy in life. Why change and undergo surgery just to fit in, when one can live the life they were given, most of the time without ever seeing a surgical table in their life.

Even though they might not face any dilemmas in the medical world, there is one area in which they can suffer in: marriage. Even if one chooses to undergo surgery to fully become a male or female, they might not be able to marry someone of their opposite sex. For example, one decides to become a female, and they want to marry a man. Sounds normal, but it might not be accepted. This is because despite legally being a female and choosing to marry a male, they both might share the same X and Y genetic makeup, causing it to be a same-sex marriage. Despite changing their sex, their genetic makeup will never be altered, causing them to still be a male and female on the inside, but just a female on the outside. It is also possible for one to have all the genetics of a male and female at the same time (XXXY). If this were the case, they technically couldn't marry anyone because no matter what they did, it would always be considered as a same-sex marriage.

This is causing intersex communities to fight for equality regarding marriage, since they believe that they should be able to marry anyone they wish, just like everybody else, regardless of what their genetics say. But it all comes back to sex reassignment at birth. Having a parent or doctor determine the sex of the child at birth can actually prevent them from marrying when they get older. Today's society is very strict in regards to what actually defines a male and a female, so any alterations made without the child's consent can lead to them not being able to live the life they wish. Once a child reaches the age to realize their gender and sexuality, then the necessary steps can be taken to not only assign them a gender, but also allow them to marry the opposite sex.

So after discussing all of the reasons why it should be left up to the patient to decide their gender, why do parents still make the decision for them? It is simply because parents can't bare the fact that they had both a son and a daughter, but only one child. As a parent, it would be hard to deal with having a child that was different from everyone else, especially in regards to their gender, so they believe that correcting it as soon as possible will not only be better for the child, but more importantly, will relieve their own stress as well. Despite being the one who brought the child into the world, they still should not be the one to call the shots for them, since every action can lead to medical, social, mental, or physical complications. In most cases the parents will do what is best for their child, but this is just one situation in which they have to learn to take a step back and wait it out.

Works Cited

Dreger, Alice. "Shifting the Paradigm of Intersex Treatment." 2008. The Intersex Society of North America. 21 Nov. 2008.Graff, E.J. "The M/F Boxes." The Blair Reader: Exploring Contemporary Issues. Upper Saddle River, NJ: Prentice Hall, 2008. 379-79.