Doctors vs. Intersex Patients

What really caught my attention in Elizabeth Reis’s "Impossible Hermaphrodites: Intersex in America, 1620-1960" was the ethical issues that were involved in many of the cases where the physicians performed surgery in which they decide the sex of their patients. In these examples, most of the doctors made these decisions due to the patients’ future marriage prospects, level of sexual desire, and other factors. Based on the text, it was noticeable how many of the patients did not have a say in which gender they identified with, especially those who were so young.

There was one case with a patient who lived the first two years of her life as a girl, but then started to shift her focus from dolls to “boyish sports.” A physician, Dr. Gross, closely examined her and found her to have ambiguous genitals in that she has a small clitoris and two testes despite her “long dark hair, dark eyes, perfectly formed hips and chest, arms and legs, and a lovely face.” Dr. Gross performed surgery to remove the testes of the young girl because he was thinking of her future marriage prospects. At that time, he strongly believed that it was better for her to be a woman with no sexual desire than a man fulfilled despite the fact that the patient was incapable of impregnation. While reading this particular case, this horrified me because the doctor made the decision for his patient simply due to her future marriage prospects. I could not believe how there was so much power in the doctor’s hands. It is unsure whether the young patient was given the free will to choose which sex she wanted to be, but it was most likely that she was not given a choice. Also, interestingly, it did not mention anything about the patients’ parents and their perspective on their child’s surgery. It was obvious that back then, there were many ethical issues involved in relating to the patients’ consent and the power in the physicians’ hands.

However, an opposite case involved a physician, Dr. Goffe who allowed his patient to have the opportunity to decide what gender the person wanted to be. The patient had physical male characteristics, yet was considered a woman by the physician because of the patient’s sexual preferences towards males. Despite Dr. Goffe’s strong beliefs in heterosexuality, thus regarding his patient as female, he asked his patient which gender she preferred to be. In this, we see the doctor giving his patient the power to choose which gender she wanted to live as. So, the patient decided to be female, and the doctor followed her wishes. During that time period, it was very rare, in fact so rare that Dr. Goffe received harsh criticism for giving his patient the power to choose genders.

Which leads me to my question: Should doctors be given the power to assign a gender to their patients who are very young or at birth? Through my research, I found that two years ago in 2012, physicians are still performing genital surgery on intersex infants at birth. In doing so, there were severe, harmful consequences especially with unsuccessful surgeries where the results are physical and psychological pain, scars, decreased sexual sensation, and many other issues. In addition, there are always the options of the person rejecting their gender assignment which is unfortunately irreversible. So, I wondered to myself, do the doctors even realize these severe consequences that they may possibly unknowingly inflict on their patients? Once I read this article, it answered my question in the form of “No.” It talked about the physicians’ reactions to the intersex woman who came to them asking for a sincere apology. They realized the true harm they have caused, and expressed regret. As you can see, the doctors should not really have that power in their hands because it is not up to them, but the intersex patient.

Though what caused these doctors to perform unnecessary and harmful “treatment” on intersex children? In fact, what caused all of these doctors to do these surgeries on children whose genitals look “not right?” It is society’s perception of what makes a human being normal in terms of physicality as well as mentality. Because the intersex are born with genitals that do not look like it should, doctors change the intersex’s genitals to a more normal shape of how it should be due to their mindset of enforcing the normality onto their intersex patients often without consent which then, violate their human rights. Nowadays, there is more awareness of intersex people and what they go through. Hopefully, we will learn to see them simply who they are as a person, instead of enforcing a gender on them, and defining them ourselves when it is not up to us.

To me, it seems that society is so focused on perfect, normal physical appearances that anything that is abnormal is immediately shunned from society which explains the doctors’ reasoning in assigning a gender to intersex people. Why do we focus so much on normality and perfection? Everyone is imperfect in some physical form of way. There are people who have scars, disability impairments, diseases, etc. Yet, we stressed so much on having the same physicality. Which brings me to my next thought: What makes a human perfect? What is perfection? Everyone has different ideas of what should be perfect, so is there such a thing as a united idea of perfection?  

As of now, times are changing, and people are realizing that everything is not always cut and dry. There are a variety of things such as sex preferences, sex gender, etc. that are fluid. Even I have learned something new from this course even though it is still the beginning of the semester. I was not aware of what intersex really meant until we read the course required readings. I actually realized that there was an in-between even within the sex genders. Therefore, I think the first step in realizing these topics is awareness.