The Unkindest Cut

Female genital mutilation–usually cast as a brutal procedure
practiced in Third World countries–has received a spate of news
coverage in the West recently. What’s been overlooked is the fact
that in developed countries radical surgery is performed routinely
on infants born with ambiguous genitals: a particularly large
clitoris, an uncommonly small penis, and all the variations in
between. The condition to be ‘corrected’ is called intersexuality,
or hermaphroditism.

Prior to the 1950s hermaphroditism was not treated as a medical
emergency. But in American hospitals today, Sarah Horowitz reports
in SF Weekly (Feb. 1, 1995), the birth of an ambiguously
sexed baby brings a team of specialists–including doctors,
psychologists, and social workers–to counsel parents on their
options. Doctors claim that surgery, the most common solution, is
no longer as destructive as it was years ago, when surgeons
routinely removed ‘clitoro-penises’–a procedure that often left
severe scarring and sexual dysfunction. Instead, doctors now
typically recess the clitoris and remove some of the erectile
tissue, which they claim prevents painful erections.

‘To compare genital mutilation of young girls in tribal Africa
to reconstructive surgery of a young baby is a giant, giant leap of
misrepresentation,’ says Dr. John Gearhart, a pediatric urologist
at Johns Hopkins medical school, which has pioneered intersexuality
treatment. Still, critics point out that the operation does
radically alter a healthy child’s body (often with multiple
surgeries and hormone treatment).

Though doctors say the goal is to produce well-adjusted kids,
social psychologist Suzanne Kessler and other critics argue that
the real purpose is to satisfy doctors and parents and to conform
to a society that remains uncomfortable with sexuality in general,
and particularly with its more complicated permutations. ‘Genital
ambiguity is corrected not because it is threatening to the
infant’s life,’ Kessler has said, ‘but because it is threatening to
the infant’s culture.’

After all, intersexuality is anything but a biological
aberration, as Anne Fausto-Sterling noted in The Sciences
(March/April 1993). For the first five weeks or so of fetal
development, all humans have unisex genitalia. Then about half
develop ovaries and female genitals, while the other half develop
testes that produce hormones that cause the clitoris to enlarge
into a penis. Some (about one in 2,000 births) develop something in
between–a uterus and a penis, one ovary and one testis, or a set
of organs that defy categorization. Their shape may or may not
correspond with the chromosomal gender markers, which in turn come
in a variety of combinations beyond the ‘standard’ XX and XY.
Fausto-Sterling claims that there are at least five sexes,
including three types of intersexuals with varying degrees of
‘male’ or ‘female’ characteristics. Indeed, she calls gender ‘a
vast, infinitely malleable continuum that defies the constraints of
even five categories.’

All this is more than an academic debate. Most observers agree
that the common surgical procedures have no direct physical health
benefits (with the exception of cases in which tissue that could
grow into cancers or become infected is removed). Where they
disagree, writes Natalie Angier in the New York Times (Feb.
4, 1996), is on the question of who needs changing–intersexuals,
or the world around them. In a recent paper presented to the Queer
Frontiers conference (http://www.usc.edu/Library/QF/papers/holmes.short.html),
Morgan Holmes, an intersexual doctoral candidate at Concordia
University in Montreal, claims the surgery is evidence of
homophobia and ‘patriarchal misogyny.’ Yet, she argues, prominent
feminists soundly condemn clitoridectomies among Third World people
and immigrants, but at the same time embrace or ignore mutilating
‘genital revision’ surgery in the West.

Cynics could argue that at a time when scientists are
investigating the gender-bending effect of certain pollutants
(Florida alligators grew hermaphrodite organs after exposure to
chlorinated compounds, for example), society better get used to
gender fluidity. Optimists like Holmes hold out the promise of a
world in which ‘sexuality is something to be celebrated for its
subtleties, and not something to be feared or ridiculed.’ If you’re
a newborn hermaphrodite, on the other hand–unless your parents and
doctors are extraordinarily courageous–you’re likely to have no
choice at all.

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