Doctors Resort To Nonsensical Reasoning To Justify Surgeries On Intersex Children

"It’s not as easy as it used to be for doctors to discuss the real motives behind Intersex Genital Mutilation."
07/28/2017 04:35 pm ET Updated Jul 29, 2017

Earlier this week, I had the odd experience, during an interview on the NPR’s Airtalk, of listening to someone blur the lines of logic and reasoning in order to make their point. It was on the segment, “Should Surgery on Intersex Children Be Banned?”, and the person doing the verbal gymnastics was trying to find a way to justify these surgeries, which intersex activists call Intersex Genital Mutilation (IGM). IGM has been the subject of controversy since the mid-1990’s, when intersex adults began reporting the severe psychological and physical harms that being subjected to it had produced. This past June, three former U.S. Surgeon Generals published a paper titled, “Re-Thinking Genital Surgeries on Intersex Infants,” calling for a moratorium on IGM, and earlier this week Human Rights Watch and InterACT issued a report calling for a ban on the practice.

Nevertheless, some, like Dr. Laurence Baskin, Professor of Urology and pediatrics at UCSF Benioff Children’s Hospitals, are reluctant to support the proposed ban. Before I explore why, I want to clarify that the vast majority of intersex children are born healthy, but are subjected to medically unnecessary surgeries in an attempt to make them fit into sex and gender norms, and it is these surgeries which intersex activists oppose and refer to as IGM—not the minority of cases where intersex children, like all children, are born with issues requiring medical attention for their physical health. Doctors have often conflated these two situations in order to either discredit activists’ goals or imply that IGM is necessary, so it bears mentioning. Also, while I don’t mean to pick on Dr. Baskin personally, his rhetoric is emblematic of the resistance intersex people face when fighting for our human rights, so it’s important to dissect it.

Dr. Baskin began his interview by using trans affirming language to make his case, stating that, “these are children, and they shouldn’t be defined by their genitalia.” Later, when asked if he thinks there are situations where it’s appropriate for a parent to opt for surgery in order to choose a binary gender for their child, Dr. Baskin replied, “Parents don’t choose a gender for their children, we all choose our own gender.”

Sounds great―someone who believes that genitals shouldn’t define us wouldn’t recommend altering genital variance right? Surely they’d support a ban on IGM and what advocates recommend: assigning intersex babies a sex (we recommend assigning whichever seems more dominant, male or female, until equal rights and protections are available for intersex people), leaving them as is, and letting them decide their own gender later on―yes? Unfortunately, no. When pressed on the issue, Dr. Baskin admitted that he doesn’t support a ban, and elaborated by giving an example of a surgery he would recommend in order to produce genitals that can participate in heterosexual sex. So it appears his LGBTI-inclusive sounding rhetoric was just a ruse.

He continued, saying, “So these aren’t what I would [call] gender re-affirming surgeries, these are surgeries to restore normal anatomy.” Huh? Last I checked “restore” meant to bring back or re-establish; to return someone or something to a former condition, place, or position (from the Oxford Dictionary). Obviously people born with atypical sex anatomy cannot be returned to a condition of “normal anatomy” which we never had, and I find it highly unlikely that the doctor is unfamiliar with the definition of the word “restore.” Why, then, would he use arguments that literally make no sense in order to justify these surgeries?

The reason, I believe, is that it’s not as easy as it used to be for doctors to discuss the real motives behind Intersex Genital Mutilation. In today’s ever evolving, social justice minded society, being perceived as an educated, intelligent person while spouting homophobic, transphobic or otherwise discriminatory viewpoints is harder than it used to be. As a result, doctors are trying to find ways to discuss IGM that don’t reveal the discriminatory motives behind it: namely, that they are so interphobic they’d rather have us disappear than simply accept us.

Dr. Baskin’s willingness to claim that babies can be magically returned to a condition they never embodied, rather than simply admitting that being born intersex is natural, is a powerful example of the severe prejudice some doctors hold against intersex traits and people. We are not formless entities waiting to be restored to male or female normalcy. We are something else, and we call it intersex, not “disorders of sex development,” as Dr. Baskin described us. The vast majority of us reject that term because it’s stigmatizing. It seeks to relegate us to a disease and erase us as a people, because you can’t form a community of “disorders of sex development.”

And make no mistake about it: homophobia lies at the heart of the practice of IGM, because the decimation of healthy intersex anatomy in order to create “normal” anatomy is based on attempts to produce bodies which can engage in heterosexual sex. Mind you, neither I nor any of the advocates I know oppose intersex people altering our bodies if we see fit. But the key words here are, “if we see fit.”

Given that the incidence of people wanting to change their sex traits is well understood, and that the option is available, why wouldn’t doctors simply recommend deferring these surgeries? Many people are born with traits that aren’t “normal,” meaning they’re uncommon―-things like red hair and green eyes—but we don’t eliminate them. Clearly doctors who recommend IGM have such negative opinions about intersex traits that they’re willing to prioritize these viewpoints over our basic right to self-determination.

Dr. Baskin went on to say that, “We need more studies on when these surgeries should be performed, and how these surgeries should be performed…” Doesn’t the fact that hundreds of intersex adults have stepped forward to report that IGM harmed them, and that they took an oath to “do not harm,” mean anything to the physicians who recommend the practice? Apparently not, because they seem to have no issue ignoring the experiences of these intersex adults—who run the gamut from doctors and supermodels to lawyers, parents and professors—in favor of their own opinions.

Prejudice is defined as a, “preconceived opinion that is not based on reason or actual experience.” As discussed on the show, there is no evidence that Intersex Genital Mutilation is beneficial to its recipients, or conversely, that growing up with intersex traits is harmful. So doctors’ refusal to support a ban on IGM is based purely on their own preconceived, aka “prejudiced,” opinions about the need for it in order to uphold sex and gender norms.

Incidentally, there’s another practice that’s based on upholding sex and gender norms, rather than science: Female Genital Mutilation (FGM). Some people really feel that it’s the right thing to do to their kids, but fortunately the practice was banned in the U.S. despite these views. I believe that, similarly, we can and soon will ban the practice of Intersex Genital Mutilation, and I thank the many doctors who are listening to intersex people’s assertion that letting us make these decisions about our own bodies is the only logical and ethical approach.

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