Sex and Gender Identity: Intersex Child

“Discuss why the birth of an intersex baby is treated as a ‘medical emergency’ and the implications of surgical sex assignment (personally and socially)

This essay will discuss why the birth of an intersex infant is considered a medical emergency, what especially determines the intersex conditions whilst shedding light on the reasons as to why surgeons deem this procedure necessary to the infant. As well as the repercussions, the surgical sex assignment will have on the child personally and socially in the future. The impact other children can have on an intersex infant and the impacts associated on the parents having to deal with this ‘medical emergency’ and the struggles associated with their sex and gender identity as they go through life.

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Physical features in which determine the sex of an individual person are the internal and external sex organs, the karyotype, gonads and the secondary sexual characteristics these appear at puberty. Whereas Intersex conditions occur when there has been an obstruction in the normal process in which sexual maturation is formed, therefore results in abnormalities in any of these features. (Creighton, 2001). Medical professionals are guarantying that surgery to adjust ambiguous genitalia is a treatment planned to re-establish a fitting appearance and function to the infant. (Holmes, 2002). In Australasia, North America and the United Kingdom it is now seen as standard medical practice to surgically and hormonally correct intersexed infants. The practice of this has been continuously justified solely on the basis that the birth of an ambiguously sexed child represents a ‘psycho-social emergency’ which is when the intersex infants’ reassignment should be addressed through surgical means as soon as possible. During the late 1990’s it saw a swift increase in interest concerning the medical treatment of intersex infants and children from medical practitioners, ethicists and even intersex people themselves. An impasse has come to light regarding the questions being asked about intersex medical treatments by clinicians and intersex activists. As clinicians are professionally bound to take and look after the well-being of their patients, the research in which they are relying on is to argue for early surgical assignment. Physicians believe intersex infants are to have surgery as soon as possible. It is believed there are in fact three categories of distinguishable genital surgery: Firstly, that the surgery is going to be lifesaving. For example, the urethra has been rerouted so that the infant is now able to pass urine out of their body. Secondly, it improves their quality of life. For example, they completely redesign the urethra opening to help the child not urinate on a toilet seat. Thirdly, aesthetic purposes. For example, the small penis is built up so that eventually when the man is older he will feel more manly. (Roen, 2004). Surgery is meant for effecting the sense of gender and sexual identity for the child, and to support him/her from a likely hostile and ignorant world. (Holmes, 2002).

Within Western culture, it is significantly committed to the idea that there are only two sexes. People can go years without knowing of their intersex surgery, but for the ones who do know or have not had surgery to give them a gender identity, it can be difficult socially, especially as a youth. Teasing is not an uncommon occurrence in this society. One alarming factor that has been noted by teachers and parents that it is not the intersex child’s behaviour, but the way in which other children are reacting to it. Even if the child is normally seen as ‘socially acceptable’ once his/her peers are to find out that they are in fact intersex, that is when their opinions can change, as intersex individuals are not seen as ‘socially acceptable’. This brings up Gender Identity Disorder and that teasing is seen as a justifiable reason to require treatment for this. Teasing and name calling can have a huge impact on a child’s wellbeing, regardless of being intersex or not. It can lead to depression, social anxiety and if the teasing got too much for the child they could then decide they did not want to go to school anymore. Prejudice over intersex children plays a role in how they are going to be treated. If a child has not had surgery and is still figuring out their identity it can be had for people, let alone other children to understand. Whereas, if a child has already been gendered from a surgery at birth, it can be easier for the child to identify themselves therefore, not have the repercussions from other children who may not understand the situation. (Fausto-Sterling, 2004). As well as issues with their parents and other children, another social impact on an intersex child can be the trauma associated with being intersex. In large part, the shame that seems to appear with being intersex. This comes back to having the surgery, as that a child is less likely to be singled out and teased if they have had a the surgery and their peers are unable to know of their differences if they have identified with a gender, which has been given with the surgery. This will then decrease their chances of life long trauma and the possible mental effects on them which can then be linked to depression, anxiety, bipolar etc. (Feder, 2014).

When looking at an intersex person’s life, there can be many factors to affect them personally. One of these is the effect on their parents. A person can only attempt to imagine the struggle a parent would go through regarding the decisions they would have to make for their baby. Whatever decisions the parents have made, for example: deciding to go through with surgery, which gender they choose to influence their child as if they do not go through with the surgery, what their beliefs are etc., This definitely has a huge impact on their child’s life. (Fausto-Sterling, 2004). It is seen that medical professionals are trying to assure anxious parents that having the surgery will then let intersexed children to see themselves as a single sexed person and gendered person. Although, what comes of this is two clear problems that will have an effect on the child. Firstly, it willingly assumes that a person who has not been through the intersex surgery would not have a clear identity, when in fact this would not be the case. Yet no practitioners have any evidence to fully support this assumption. Secondly, it suggests that a ‘typical’ man or women feel completely at ease and happy in their bodies and their gender identities, and do not have any issues regarding their body image and relationship of identity to their appearance. Yet in fact there are many crises that affect men and women regarding their sex/gender. Individuals may have troubles in their self-image such as problems with how much body hair they have, they may have too much to be ‘properly feminine’. Or not enough hair to be ‘properly masculine’. Yet surgeries to change the appearance of one’s sex, are now offered to parents as guarantees that their intersex infant will grow up to be a full male or female. (Holmes, 2002). This then looks at the issue that if an infant is placed under a certain gender but as they grow older are to feel more like the opposite, what kind of impacts can be associated with this? As well as mental impacts, there can also be resentment towards the people in which made this life altering decision for this person, for example their parents, the surgeon. It can also have a huge impact on their wellbeing and how they are feeling about themselves as a person. It can bring up a lot of questions and feelings of doubt within themselves. Having the surgery right from birth can have a lot of negative impacts on the person personally. (Holmes, 2002).

To conclude, this essay has covered a wide range of topics regarding intersex infants and whether or not the surgery is worthwhile to them and the effect it can have on them personally and socially. As well as the people they may associate with in day to do life, their parents, their peers and what kind of impacts and influences they can have on this persons life.  How does having the surgery effect their sexuality and gender identity. These are all factors that can have huge influences on an intersex person’s life that can shape them into the person they will eventually grow into in the future. If people became more open to accepting an intersex person, they may learn a thing or too.

References:

Creighton, S., 2001. Surgery for intersex. Journal of the Royal Society of Medicine, 94(5), pp.218-220.

Fausto-Sterling, A., 2004. ‘The Five Sexes: Why Male and Female are Not Enough’, in Michael Kimmel and Rebecca Plante (eds) Sexualities: Identities, Behaviours and Society, pp. 39-44. New York: Oxford University Press.

Holmes, M., 2002. ‘Rethinking the Meaning and Management of Intersexuality’, Sexualities, vol. 5, no. 2, pp. 159-180.

Roen, K., 2004. Queerly Sexed Bodies in Clinical Contexts: Problematizing Conceptual Foundations of Genital Surgery with Intersex Infants

Feder, E.K., 2014. Making sense of intersex: Changing ethical perspectives in biomedicine. Indiana University Press, pp 48