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The Biology and Medicine of Sex and Intersex

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Hannah Valley

on 3 February 2014

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Transcript of The Biology and Medicine of Sex and Intersex

The Biology and Medicine of Sex and Intersex
Surgery is suggested and given immediately to babies if they notice the child is intersex.

Doctors encourage early genital surgery

With the surgery doctors are looking to correct any structural "abnormalities" that would change the way a traditional adult sexually functions or would increase that persons risk of a Urinary Tract infection
How intersex is typically treated
Is It Ethical?
Many adults who underwent these surgeries as children and are unhappy with the results are now questioning whether or not their parents should have had the right to make this decision for them
Although many people who had these surgeries did end up adjusting well to the choice made for them, is that worth the amount of people who do not feel comfortable in the sex assigned to them?
Debates about Treatment of Intersex Persons
Intersex: general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male; a socially constructed category that reflects real biological variation. (Isna.org)
Fetuses start out as indifferent with identical phalluses
Layers of sex can develop independently of each other --> a child can be born with a mixture of layers (intersex) (Fausto-Sterling)
Intersex is complex, many different categories
About 1 in 2000 babies born intersex annually
Developmental Events that Lead to Intersex in a Newborn
Androgen Insensitivity Syndrome: Genetic inheritance of a change in the cell surface receptor for testosterone. XY newborns born with highly feminized genitalia. Develop breasts and "feminine" body shape during puberty.
Gonadal Dygenesis: Umbrella term, not all genetic. Refers to mainly XY children whose gonads don't develop fully/properly.
Turner Syndrome: Female-assigned babies who lack a second X chromosome (X0). Ovaries do not develop, form of gonadal dygensis, short in height, do not usually possess expected female physical traits.
Klinefelter Syndrome: Male-assigned babies with XXY chromosomes. Form of gonadal dygenesis, causes infertility. Breast-enlargement after puberty.
Chinese baby was born, doctors did not have technology to discover sex based on chromosomes
Parents thought it was a boy with a small penis, but doctors insisted they should raise it as a girl
The baby underwent surgery to remove the penis
At 4 years old, the parents found out that "she" actually had a Y chromosome
From then on they raised the child as a boy and he chose to stay a boy for the rest of his life
The surgeons tend to recommend to a person who is intersex to become female.

This is recommended to a person because it is easier to create a "functional" vagina than a "functional" penis
Baby was born with typical girl parts, except for an enlarged clitoris
Her parents decide to have her undergo surgery to reduce the size, with a goal of making her look more "normal"
At age 4 she insists that she is actually a boy, and after some time her mother agrees to raise him as a boy
Could never have a healthy sexuality or fertility
Case #2
Once the surgery is over the child has to take medications to help their system develop in the way of the surgery they were just given.

It is also recommended by doctors to parents to raise their child to know little information about their medical condition. Thus creating controversy on whether this surgery is morally admissible.

Medical treatment of intersex babies raises questions
Many intersex newborns undergo surgery to alter the appearance/function of their genitals to appear "normal" and to be able to perform heterosexual intercourse
Heteronormative and problematic
Many surgeries on these babies are simply for aesthetic purposes, they are not truly intersex
Ex: baby girl with very large clitoris has it removed and cannot feel sexual pleasure later in life. She is not intersex but has an "abnormal" body due to not fitting into societal norms
Demonstrates desires to define "normal" bodies, maintain the gender binary, and deny difference
Intersex Bodies as States of Exception
Georgian Davis & Erin L Murphy
2006 American Academy of Pedriatrics consensus statement advised against surgical modifications for intersex infants
Doctors continue to perform these surgeries on healthy babies
Medical professionals use
to convey
covert necessity
intersex bodies are
states of exception
where surgery on healthy bodies becomes necessary
How does sex develop "normally" in a fetus?

What is sex and how does gender develop?
Typically, sex is defined as two things. It can mean intercourse or it can also be another term for one's gender, meaning in our world stereotypically, either male or female.
However, it is not this simple. "Normally", it is believed that at the point of conception, either an X or Y chromosome attaches to the egg and the gender is immediately determined.
John Money
Psychologist, John Money, understood that gender develops in many ways and is not that simple
He believed that there were layers of sex that occurred which helped to determine the gender
Changes occur during these layers that influence the gender of an individual
Layers of Sex
chromosomal sex
When the chromosomes are developed X and Y along with autosomes
fetal gonadal sex
testes and ovaries
8wks or 12wks
fetal hormonal sex
once the gonadals are developed this stage is reached
internal reproductive sex
uterus, Fallopian tubes, vas deferens, etc.
genital sex
around the 4th month, external genitalia is developed

Case #1
Mental health issues in intersex persons who had corrective surgery:
learning disabilities
anxiety disorders
Physical health issues in intersex persons who had corrective surgery:
delayed puberty
sexual dysfunction
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