PicturedIdentity columnist Lynnell Long ( above ) and Riki Wilchins, founder and executive director of Gender Public Advocacy Coalition
In a move that some have hailed as groundbreaking, researchers told physicians at a Feb. 18 meeting of the American Association for the Advancement of Science to postpone surgery for intersex children until they determine their own sex.
Dr. William Reiner of the Oklahoma University Health Science Center told the gathering that ' [ t ] o discover who or what a child is ... you have to ask [ that person ] ,' , according to an Associated Press report.
Reiner, who once performed sex-reassignment surgery on babies as a urologist, said that doctors once thought that external reproductive organs were enough to determine gender. However, he began seeing children who were assigned to one gender as babies but identified themselves with the other as they grew older. Reiner then became a psychiatrist to study these children. His latest review of children found that over half of the genetic males crossed over to become boys even though they were raised as girls —with some starting the transition as early as 4-1/2 years old. These results have led Reiner to advise parents to wait before agreeing to surgery for an intersex baby; he feels that there is no need for an intersex individual to go through the agony of irreversible surgery in addition to social trauma.
Dr. Eric Vilain of the University of California-Los Angeles echoed Reiner's thoughts at the conference. Vilain identified 54 genes that work different in male and female mouse embryo brains just a few days after conception—and before sex hormones are ever made, underscoring that gender can be independent of genitalia.
'Intersex' is a term that describes approximately one in 4,000 babies born with male and female characteristics. One of the most common combinations is called congenital adrenal hyperplasia. While in the womb, genetic girls with XX chromosomes are exposed to such high levels of androgen ( the hormone responsible for male development ) that they appear male externally while possessing female reproductive organs.
Reactions to the researchers' recommendation has generally been positive from the intersex community. Lynnell Long, a local activist, told Windy City Times that she feels 'really good that doctors have finally started to listen to intersex activists and older individuals who wish that people had waited for surgery. It was great for Dr. Reiner to [ air ] his opinions where they can be widely viewed.' Long added that parents probably will listen because physicians can make more of an impression saying the same thing that an intersex advocate urges: 'For some reason, parents tend to think that doctors are God so they listen to them more than they would to someone who been in the same position.'
Riki Wilchins, founder and executive director of Gender Public Advocacy Coalition, also praised Reiner's advice. 'I think that there has been this growing awareness in the medical profession for some time that the treatment protocols for intersex children were seriously out of joint, hyper-aggressive, and intersex-phobic. This announcement is an acknowledgment of that—and it's long overdue,' Wilchins told Windy City Times. 'Doctors are recognizing that [ intersexuality ] is not a medical emergency; they now feel that they should see what gender the child is and, if possible, let the child participate in decisions regarding surgery.' As for what to advise the parent of an intersex baby, Wilchins simply recommends 'loving your child and not taking any unnecessary and irreversible medical steps.'
Cheryl Chase, executive director of the Intersex Society of North America ( ISNA ) , agreed that the doctors' recommendation was good but felt that key elements were omitted. 'The AP article completely missed the legal aspect,' Chase remarked to Windy City Times. ( Indeed, ISNA's Web site mentions several legal issues, such as individuals being denied civil rights because they do not fit into a particular gender. ) 'Also, the article said that surgery shouldn't be done because the child may not turn out to be the sex that you pick. That's true, but what's really important is ... the child may turn out to be really unhappy—even if you get the sex right. A lot of these surgeries are performed on girls who grow up to be women who are upset that someone removed parts of their clitoris and rearranged parts of their vaginas. That is definitely harmful.'
