Saturday, August 22, 2009

Caster Semenya - An Intersex Perspective

Controversy and a lot of prurient interest exploded into the news this week when South African Caster Semenya outran her competition in the 800m world championships by a more than two second lead, only to be accused of cheating by being intersex. As an intersex person following this story, I've felt . . . well, largely appalled by what spews from the mouths of competitors, sport officials, news commentators, bloggers, and eyebrow waggling, head-shaking people on the street. It's hard not to feel depressed encountering innumerable snarky statements such as this one: "South African runner Caster Semenya (hehehe...she has semen in her name...hehehe) won the gold in the women's 800-meter at the World Championships in Berlin last night, but officials may snatch (peen, I mean, pun intended) away her victory if it turns out she's really a dude." (That one can be found here, if you're really inclined to read it.) So I wanted to share my perspective on this story. I do apologize to Caster for joining the pile of people giving her no privacy, but as the media are overflowing with details of her life already, I at least wanted to step in to defend her.

The basic outline of Caster's situation, as best as I can understand it through news reporting which is mediocre at its best, is that she was born intersex, assigned female sans surgery based on her predominant genital appearance, and raised as a girl. However, like lots of us whose genitals are visibly intermediate, she grew up knowing she was not a typical female, which liberated her from gender conventions. She was a classic tomboy, refusing to wear dresses and competing with boys in sports. From what I can gather from the news, Caster did not, however, question her female sex assignment, only gender role limitations. An excellent athlete, chances are that she was defined by her physical abilities, as are many tomboy athlete girls with typical female anatomy. When she began to compete in major sporting events, her status as a woman was questioned, and Athletics South Africa "cleared her," declaring her female. Now that she has proven her remarkable running ability on an international stage, her international competitors want her disqualified for "cheating" by not "really" being a woman. The International Association of Athletics Federations has stepped in and is investigating her status, in what most news sources are oddly calling "gender testing." Generally, the news media assume that they will be able to issue a definitive answer on what her "true" (dyadic) sex is.

The main thing that saddens me about this story is the emotional tone of the commentaries. Other athletes, people on the street, and low media blogs are full of sneers and winks and nosewrinkled disgust. The major media bring in scientists and voice patronizing sympathy for how humiliating this must be for Caster, meanwhile capitalizing on the prurient interest in the story to gather viewer attention. Underneath it all is a widespread impulse to yank down Caster's pants and let everyone have a good look. It's a freakshow, with an intersex person the object of millions of prying eyes.

Some basic themes that will be familiar to anyone intersex arise over and over in the news coverage. There's ignorance of the very existence of intersex people, evinced in frequent speculation by laypeople that Caster must have had a sex change or engaged in doping. There's confusion of physical sex with gender identity, with detractors, including some of Caster's competitors, referring to her with male pronouns and speaking disparagingly of her butch appearance. There's racist scientific hubris, with Western sports scientists asserting that they can determine Caster's "true" dyadic sex after doing an exhaustive investigation of her chromosomes, hormone levels, anatomy, gonadal tissue, and psychology, while speaking derisively of the ASA's investigation as being unsophisticated. And most of all, there's the overwhelming belief in the myth of dyadic sex. Caster must be female or male; intersex cannot exist as a sex category.

One depressing sideline of this insistence that Caster must have a definitive dyadic sex is the regularity with which the term "pseudohermaphrodite" is raised by detractors. I've posted on how this term emerged in Western medical science to try to define away the existence of intersexuality ( see here.) Basically, in trying to erase the challenge intersex people place to the medical ideology of sex dyadism, doctors in the 20th century decided to call all intersex individuals who did not have ovotestes as their gonads "pseudohermaphrodites," no matter what their anatomy or experience. Somebody can be raised female, with average-looking genitalia and secondary sexual characteristics such as breasts, living a typical valorized heterosexual life, femme as can be (housewife, reader of romance novels, cookie-baker), yet all unaware, have internal testes and androgen insensitivity syndrome. If she goes to a doctor for treatment of infertility, suddenly she'll find herself labeled a "male pseudohermaphrodite." The medical term defines her as "really a man," not even intersex, let alone a woman. Anyone with testes is "really a man" according to this scheme of classification--which reveals the sex politics and semantics in supposedly "objective" science.

Those same politics emerge from the mouths of Caster's detractors. She is a "pseudohermaphrodite," they claim--not a woman, not even intersex, but a man trying to cheat honest female competitors.

Here's an irony for you. According to Western medical practice, the majority of infants discovered to be intersex are assigned female. This is done for surgical convenience (it being considered easier to remove an "inappropriate" penis than create an "appropriate" one), and due to a covert assumption about gender psychology, that women can deal better with gender ambiguity than can men. So we're assigned female, told we are "really women," subjected to mutilating infant surgery, expected to identify as female, not intersex, told to keep our medical history, if we know it, a secret, and sent out to live dyadic female lives. Many of us carefully live by the rules. But it turns out that if we do as we are told, we are still subject to being outed, discredited, mocked, and returned unceremoniously to the status of intersex oddity, as Caster's life illustrates--accused of breaking the rules.

What Caster's situation illustrates, from an intersex perspective, is that we exist. Dyadic sex is a myth--sex is a spectrum. Hormones, chromosomes, genitals, gonads--they are all arranged in many complex ways, and imposing a binary onto them is arbitrary. It's as arbitrary as saying all fruit is either sweet or sour. Sure, ripe cherries are sweet and ripe limes are sour, but most fruit gets its savor from both tastes, and some fruits balance at the tangy sweet-and-sour midpoint. You can measure all the fructose and ascorbic acid you want, scientifically. You can create a rule that divides all fruit into sweet and sour categories using precise measurements of sugars and acids. But that will not eliminate the fact that the experience of tasting fruit is complex, and that this complexity is what makes eating fruit delicious.

Given that sex is a spectrum, and that some of us live near its center, being obviously intersex, society needs to deal with us in better ways than by denying our existence, hiding us medically, and then reasserting our existence to disqualify us from participating in sports. And let us acknowledge that this disqualification is based on the insulting assumption that "real women" are categorically inferior to "real men."

Really, what Caster's case makes us consider is the strange fact that athletics are divided along dyadic sex lines. Sensibly, if one is looking at any particular sport, advantages exist according to physical distinctions--tall, long-legged people do better as hurdlers, for example. But millions of female-assigned people are taller and have longer legs than a typical male-assigned person, so why is gender and not leg-length used to create categories of competitors? There are significant differences in average height by race/ethnicity--would you therefore suggest that we divide people by race for sports competition? That would be no less arbitrary than dividing competitors by gender, though today it would be much more controversial. A much more sensible approach would be to create competitor classes by relevant physical category--as weightlifters are divided into weight classes. Then the question of "true" dyadic sex would be as irrelevant as the question of "true race" for athletic competitors.

My heart goes out to Caster Semenya, an intersex sibling caught in an impossible position--required to live in a dyadic gender, and then accused of wrongdoing because the assignment suits poorly.

Tuesday, June 16, 2009

We've Always Been Here

I exist.

When is the last time somebody told you that there is not such thing. . . as you?

OK, perhaps that's not an experience you've had, but I encounter it periodically. This morning I had a frustrating experience with a person who insisted that intersexuality is a myth. He was certain that sex dyadism was an unassailable natural fact--that people and animals come in two flavors, male and female. In his mind, hermaphrodites and centaurs and dragons were equally mythic creatures, and equally likely to be waiting in line at the store with him.

Really, what this guy objected to was my appearance, which is androgynously masculine. He wanted me to "make up my mind." Basically, he objected to genderqueering on the grounds that gender identities must be dyadic because bodies are sexually dyadic. When I pointed out that I am actually intersex, he dismissed me as making a deluded, faddish assertion. He compared me to a furry, and dissed me and furries together as crazy folk possessed by a trendy madness. He told me to "grow up."

How would you respond to that? Am I expected to walk around with an MRI in my pocket? I've already posted how people don't get to do a pants check on me.

I choose to respond less personally, with empirical data, scientific and historical. Though in truth, when people are religiously attached to a belief in sex dyadism, all the empirical evidence in the world may fail to convince them to let go of their dogma. That was the case in my conversation this morning. Still, others may listen, so I share some data you can use should you find yourself in a position like the one I was in today.

The Divine Androgyne

Many--perhaps most--world religions incorporate divine androgyny. This reflects the presence of intersexuality in the collective unconsciousness. Angels in Judeo-Christian tradition are neither male nor female. In Greek mythology, the child of Hermes (the jock god) and Aphrodite (prom queen goddess of love) was Hermaphrodite, as seen in the image attached to this post. The ancient Egyptian god/dess of the Nile was Hapi, whose breasts and phallus were depicted as constantly flowing with fertility, like the Nile itself.

Some intersex advocates are uncomfortable discussing intersex deities in the world pantheon, because they feel it links us with fantasy.
But mythos is based in fact--sometimes psychological, and sometimes material. It can be very useful. Psychologically, it can give us validation, and materially, it gives us clues to the historical past. After all, Homer's city of Troy was considered mythic until archeologist Heinrich Schliemann took the Illiad seriously and located and excavated Troy's ruins.

What the myths of the world show us is that intersexuality did not signify barren disorder, as it does to Western doctors today. It signified perfection (for the Judeo-Christian), beauty (for the Greeks), creation (for the Egyptians).

Cultural Traditions

More important from the empirical position of "proof" of our eternal presence are the cultural traditions that societies have all over the world for giving social roles to the intersex. For example, I'm Jewish. Jewish religious practice is traditionally highly sexed and gendered--males are circumcised on the 8th day of life, females must immerse in a mikvah after completing a menstrual cycle. What then of intersex children? The gemara instructs that intersex children (and animals) are given two additional gender titles, androgyne and tumtum. A Jewish child whose genitalia include both a clitorophallus and an invagination is an androgyne, and must follow all of the rules applying to males and females. A child without significant external genitalia is tumtum and is exempted from all gendered rules.

Intersex people have been born into all cultures throughout history, so there are many traditions for giving them a place in society. As intersexuality has been erased by modern medicine, the meaning of these traditions has often shifted or been forgotten. For example, Native American traditions for giving a socially valuable place to the two-spirited are now typically understood as relating to lesbian, gay, or transgendered individuals, while the home they gave to intersex children is largely forgotton. The Hawai'ian role of mahu is another example. Today, the word "mahu" is often assumed to mean crossdresser, and has taken on a derogatory edge, like "fag." But in Hawai'ian tradition, intersex children were deemed mahu, and it was an important social role. Individuals who were mahu memorized oral traditions, were instructors of the revered hula, and were consulted when infants were named.

Scientific Evidence

It seems ridiculous to present scientific evidence that intersex conditions exist--rather like gathering scientific evidence that some people are born with red hair, or that animals of all sorts have albino offspring at times. But for convincing those who demand such evidence, some facts.

Intersexuality is common in pigs. The people of Vanuatu revered intersex pigs, and carved their likeness, genitalia and all, onto statuary and bowls. British farming tradition was less appreciative. Intersex livestock were called freemartins, and in some localities killed at birth.
In the U.S., where the most revered animals are our domestic pets, intersex is studied by veterinarians in cats and dogs. Intersex conditions have been studied by scientsts in goats, in primates, in mice, in horses, in smallmouth bass . . . in fact, just about any animal you can name.

The Moral of the Story

Intersex happens. It always has happened; it's hardly some new discovery or "fad." In fact, the fad in the historical story is the recent medical erasure of intersex people, our surgical alteration, and the attachment of shame to our bodies. We've been made so invisible that most people in Western nations aren't even aware we exist, and can voice the myth that we are mythic right to our faces. Let's hope that this fad passes soon.

Monday, May 25, 2009

Viewing Intersex Genitalia (Note: Explicit Artwork Included)

Disclaimer

This is a drawing I did of the genitals of an intersexed person. If you don't wish to see explicit material, please skip this post. If you are an intersexed person or an ally of ours who is concerned that posting images of intersex people's genitalia is abusive, please read my previous post. I discuss at length the many ways that photographs of us are exploited by medical practitioners and others, and why I believe humane images are necessary. Thanks.

Does a Picture Paint a Thousand Words?

When you look at the drawing above, what do you see? I see a set of external genitalia, an intersexed set that falls pretty near the center of the spectrum of male-to-female genital arrangements. Most people in our particular culture and historical moment apparently see something else. They see. . . something wrong. They want to know what it means. They want to be told whether these bits belong to someone who is "really a man" or "really a woman." And the authority they turn to to answer this (impossible) question is not the person possessing the genitals, nor regious authority, nor social scientists, but the medical profession.

Doctors get a lot of prestige from being the people who get to interpret life's mysteries for the masses. And they have an answer. I'll tell you what that answer is in a little while, but first, before what you see gets filtered through the medical lens, let me describe the structures you see depicted.

Anatomy of an Intersex Person

There are a great number of intersex bodily configurations, both internal and external. Our genitals come in many shapes and sizes--as in fact do those of people who are not categorized as intersex. What you see in this set of intermediate genitalia includes a phalloclitoris of intermediate size. Apparently many people experience something similar to a foreground-background illusion looking at the phalloclitoris (you know, like the illusion that looks either like two faces or a vase, which you can see here). They see a little penis, then a big clitoris, then a little penis. This flickering view has nothing to do with the genitals themselves, but with the lens of dyadic sex we've been trained to expect. This illustrates how we don't just see the world-in-itself out there, but a filtered view that imposes cultural understandings onto what we see.

The shaft and glans of this individual's phalloclitoris are mostly covered by a sheath of sensitive skin that we learn to call a clitoral hood or penile foreskin--again, dyadic terminology. The sheath of skin is bound down on either side, and the underside of the phalloclitoris is attached to the individual's body. Thus, when this person's phalloclitoris erects, it does not stand out from hir body but stays tucked close, pointing rearwards, as is typical for a clitoris.

At the center of this person's genitalia you see an invagination. It is fairly shallow, unlike the deeper vagina of someone with a classic female genital configuration. It is lined with delicate, lubricating skin. The urethral meatus ("pee hole") is in the central slit of the invagination.

Around the shallow invagination you see structures which are intermediate between labia majora (in female anatomic terms) or scrotum (in male terms). In this individual, there are testes that have descended and are held within the labioscrotum.

What Doctors See

As I've explained in an earlier post (here), doctors are the enforcers of sexual dyadism, and see all people as having a "true" or "best" sex, either male or female. Most often they like to assign intersex people to be female, and they remove or "reduce" our phalloclitori. They believe, though they tend not to say this, that it's better to be a female-assigned person with a surgically-constructed clitoris that feels nothing than to be a male-assigned person with a small penis. What they say, I kid you not, is that "it's easier to make a hole than a pole."

Doctors still take the "hard route" and attempt to construct a penis at times, and it's in individuals like the one whose genitals I've drawn here that they are most likely to do it: those with external testes. Internal ones they generally remove, claiming they pose a risk for cancer, but external ones they tend to leave in place. Finding external testes, doctors proclaim an intersex person to be "really male." Therefore, doctors looking at these genitals don't see a person of intermediate sex, they see a male with a "disorder of sex development" that they would term "perineal hypospadias with chordee."

On Hypospadias

As I've said, genitals exist on a spectrum. People with hypospadias run along the spectrum from maleformed genitals to the smack-dab center illustrated in this post. In people with what doctors call "first degree hypospadias," the genitals include typical testicles and a penile form that varies from the average male's only by having the urethra open, not at the center of the head of the penis, but on the underside of the head. Generally, the further down the shaft or perineum that the urethra opens, the more intermediate the genital form (doctors would say "the more severe the malformation").

Doctors almost always propose surgery for infants with hypospadias, even when there is only a small shift of the urethral opening. This causes scarring and loss of sensation, perhaps very mild, or perhaps leading to full numbness of the penile head and underside of the shaft. Constricted areas, holes that leak urine ("fistulas"), and recurrent bladder infections are common side effects, but are all deemed by doctors to be outweighed by the benefit of surgery. That benefit is basically avoiding the social mockery doctors presume is unavoidable for people with atypical genitals--the "locker room factor." Many male-identified people who had childhood surgery for minor hypospadias are very critical of the decision that was made for them, and, like intersex advocates, argue that no genital surgery should be performed unless and until a person grows up and chooses it. They'd rather have a penis with an off-center urethral opening that is fully sensate than a numbed phallus with an on-center urethra.

For people with perineal hypospadias, the consequences of surgery are more severe. Instead of having the functional genitals with which they were born--atypical but sensate intersex genitals that lubricate, erect, and experience pleasure--they wind up with small surgically-constructed penises that may be severely scarred and mostly numb. Instead of simply sitting down to pee, they may deal with multiple fistulas, a stuttering urine stream, and frequent bladder infections. In individuals with chordee, as in the drawing, since the clitorophallus is joined with the body, part of the glans and/or shaft will be cut off, left buried in the perineum or excised completely. Often there are multiple repair surgeries over the course of childhood--which is a source of stigma, not a shield from it. And significant numbers of these individuals grow up not identifying with the male assignment they were given, and in deep distress over the loss of genital forms they wish they had been permitted to retain.

The Moral of The Post

If people could look at intersex genitals and actually see them for what they are, a great deal of pain and suffering would be avoided. What you see in the image is an intermediate genital form, not warped female genitals or disordered male ones. When a child with intermediate genitals grows up, zie may identify as female, or male, or intersex, and should be allowed to decide what surgery if any is appropriate--but few get that chance. Wrong decisions are made for us all the time, and this happens in large part because our families have never seen genitals like ours before. They don't know how to interpret what they see because they have no context. So they turn to the doctors, who get a lot of prestige (and money) out of diagnosing us, selecting a dyadic sex for us, and surgically altering us without our consent. And not knowing anything about intersexuality, families go along. It's for this reason that I think it's so important that people see images of the full genital spectrum.

Artwork by Luminis, marker on paper, digitally manipulated. Copyright retained.

Wednesday, May 20, 2009

The Intersex Peep Show

No, You Can't Look in My Pants

Since I started coming out publicly as intersex, I've been asked by some people I've barely or never met to show them a photo of exactly what I keep between my legs. This is a very odd question--consider how you'd react if you received this request from some stranger. It can be disconcerting and creepy to realize that someone you don't know is thinking about your genitalia, requesting a photograph.

So no, I don't spread my legs for strangers. And motivation doesn't matter much to me in answering requests. Some people ask because they're kinksters. Don't get me wrong--I support everyone's right to their consensual kink--but I have not consented, and they don't get to play. Other people ask because of simple intellectual curiosity, and I support intellectual curiosity too. But I am not a specimen any more than I am a porno spread. I'm a person, entitled to my dignity.

Recently somebody contacted me wanting me to describe my genitals and my surgical history so zie could feel confident I was really intersex and not some poser. And while I empathize with intersex people feeling used or misrepresented, the answer remains no, you don't get to look in my pants to perform your gatekeeping.

But How Can We Not Discuss Intersex People's Genitalia?

This is an entirely different question than asking to see my. . . jonk. You're right, it seems odd to discuss intersex status without discussing genitals. I do want to point out that we discuss male experience, female experience, and the experiences of androgynes and genderqueer folk all the time without discussing their genitals. We don't ask to verify what they've got down there before discussing their gendered lives. And what defines intersex experience isn't genitalia but the social reaction to our bits--the way our very existence seems to create a crisis for medical professionals, families, and ordinary folk. There's no need to discuss our genitalia to address that social reaction.

But. I do think we should, as a society, discuss genitalia. How they come in a wide variety of configurations, a spectrum not a binary. We need to be aware of variation, not just in the genitalia of those of us labelled intersex, but those considered unproblematically male or female. Lots of nonintersex people feel anxiety about whether their genitals are "normal," or too small, or too loose, or too asymmetrical. We should know what genitals really look like. And a picture does paint a thousand words.

What's Wrong with Pictures of Genitals

The photos and illustrations of genitals most people see are highly problematic. They do injury both to the viewer and the person being viewed. Mostly, we're exposed to two sorts of pictures: either pornographic images, or medical ones.

I'm strongly opposed to censorship, and I stand up for the right of people to produce and view porn, but most of it is terrible. I'll mention two of the reasons why: first, most porn does harm to the viewer by showing a single "idealized" vision of the human body, and secondly, it harms the models (especially the female-assigned ones) because they are viewed by our sexnegative society as whores and perverts. From an intersex position, the representations of "us" as "hermaphrodites" in most porn are actually usually photos of nonintersex male-to-female trans people financing their transitions by filling the demand for images of "chicks with dicks." In a world where sex transitions are both costly and not covered by medical insurance, and where trans people suffer profoundly from employment discrimination, I empathize with the "herm" porn models. But the fetish market that they feed gives people a very skewed perspective on the lives of intersex and trans folks, and this peep show teaches people very little about what intersex people's parts look like.

Then there are clinical medical images, of two varieties. One are the sort of illustrations we see in educational contexts. For example, buy a package of tampons or condoms, and you'll find instructional illustrations included. Intersex genitals are never pictured, but really, few people's genitals look like the images you see. The illustrations in the tampon packages are almost always hairless with tiny symmetrical labia minora--they look prepubescent, and prepubescent people don't get menstrual periods. The penises in the condom illustrations are all circumcized, erect at a high angle, and look more like a hot dog than a human. Clinical educational illustrations seem designed to make ordinary people feel anxious about their genitals, their small penises and large clitori,
their veins and moles and asymmetries and hair.

Still, at least nonintersex people see illustrations that somewhat approximate their bits.

If you want to see what intersex people's genitals look like, you have to turn to another sort of medical image: the clinical photograph. And the photographs range from depressing to truly appalling. Generally they're photos of children, taken without their consent. Sometimes you can see that the child is being held down. Orifices are stretched open by adult hands, foreskins are pulled up in the jaws of forceps, and ruler scales cut into delicate skin. The photographs are utterly dehumanizing--people reduced to "disordered" genitals and treated as specimens, with as much consideration as a doctor would show a biopsied sample of a tumor. It's as much horror show as peep show. Intersex children are treated as freaks, forced to spread their legs, and hurt without their consent--and because it's done in the name of Science, it's supposed to be OK.

It's not OK.

My Complicity, My Shame

The lack of education about intersex genitals is harmful in multiple ways, and one of them is that it makes us into peepers, and collaborators in the abusive treatment of intersex children.

I grew up knowing I was genitally different, but unsure of what it might mean. By my early teens I was looking through medical journals for pictures that might tell me more. I'll post sometime on my academic research on teratology, the branch of medicine that deals with "birth defects"--suffice it to say for now that I've looked at a lot of medical images of intersex people. And I can try to justify it in terms of personal need and academic critique, but in the end, I'm complicit. Not that I've ever sent a stranger an email saying "Can you send me a photo of your privates?" But I've contributed to maintaining the market for exploitative and abusive medical photography of intersex people.

What Can Be Done?

It seems to me that there is a real need for a collection of cruelty-free, nondistorted images of intersex people's bodies, including our genitals, for people to view. I imagine that illustrations would be best. There may be people out there with various intersex conditions or "DSDs" who would be willing to be photographed by a respectful ally for a public image gallery, but I suspect most people, like myself, would be very wary of the idea. Drawings would avoid the issues of shaming or disrespectful use of our bodies. Ideally, they would be nonidealized. They could be warm rather than clinical, human rather than dehumanized.

I'm going to try my hand at it. I'll see if posting a drawing turns my blog from the intersex roadshow to the intersex peepshow--I certainly hope not. But it does seem like an important project to me.

The image in this post is a manipulation by me of a photograph provided under a Creative Commons license by just.Luc here.

Thursday, May 14, 2009

On Being Called a "True Hermaphrodite"

I was born with an ovotestis, which is a gonad that is intermediate between an ovary and a testis. The medical terminology for a person born with an ovotestis is "true hermaphrodite." Today I'm going to post on what I hate about that term, and what I don't.

The Reality of Intersexuality

The reason people with ovotestes were termed "true hermaphrodites" by doctors was explicitly to categorize all other intersex people as not "truly" intersexed. Most intersex people were medically deemed to be "pseudohermaphrodites." This was based on an fundamental (and, to my mind, fundamentally evil) impulse to erase our existance.

The medical "logic" basically went like this: nature makes things male and female. Laypeople might doubt this when they see a person with intermediate genitals, but doctors know better. With Science they can tell the "true sex" of these people, and eliminate the challenge to sex dyadism.

It's a strange exercise, looking at people whose bodies are neither male nor female, and deciding you can tell what they "really are." Let's say you're looking at someone who has breasts, a menstrual period, and a penis. What are they "really"? You can come up with a rule and apply it, but that rule will be arbitrary. It's just like looking at the color purple and saying, "Purple is not a real color, so this must be either blue or red. I have a Scientific Rule I can apply to determine whether this is blue or red." Sure, you could create a rule, and apply it consistently, but that does not eliminate the fact that purple exists as a color people experience.

This belief that intersex people "really didn't exist" when they were standing right there was like some oddly theoretical genocide. At the time that the terms "male pseudohermaphrodite" and "female pseudohermaphrodite" were coined, sex assignment surgery had yet to be developed, so it was a purely verbal move to erase us.

Harmful Practices

Today, sex assignment surgery does exist. And the persistance of a medical belief that doctors can run tests on an intersex baby and determine hir "real sex" has harmful effects. Children are subjected to profoundly lifealtering surgeries without their consent. Imagine if someone cut your penis off without your consent, or removed your ovaries and chance for fertility. . . and when you cried, "What did you do to me!?" they said, "Oh, our tests showed you didn't need those."

Intersex advocates of every stripe are vehemently opposed to infant sex assignment surgery. They say, we say, that no surgery should be performed until a child grows up and can say what surgery (if any) zie wants. The foundational principle should be an individual's gender identity. A baby with CAH can have a penis, ovaries and uterus. If that baby grows up and identifies as a boy, then he may choose to have his uterus and ovaries removed. If the baby grows up and identifies as a girl, she may choose to have sex assignment surgery to change her penis into a clitoris.

Or how about this? The child could grow up with a gender identity that matches hir body. Zie could say, "I'm not 'really a boy' or 'really a girl,' I'm really intersex, and I don't want any surgery. My body is fine, lovely, just how it is, thanks."

As it now stands, that option isn't on the medical table. Doctors are still assuming that all of us must have a true sex, or "best sex" in the terms of the day, and that they are heros because they can fix us.

The Term "True Hermphrodite"

I hate the term "true hermphrodite" for two reasons. One, it deems most intersex people "false," not really intersex, which both leads to harmful practices and undermines people's ability to identify with their bodies as intersex. And secondly, it gives me some sort of privilege I don't want. I'm deemed the "real intersex," I'm "true." I certainly don't see myself as "more intersexed" than other intersex people, and I don't want to be seen as special or better.

The reason I'm termed a "true hermaphrodite" is because the arbitrary rule that doctors came up with when they developed the terms "true hermaphrodite," "male pseudohermaphrodite" and "female pseudohermphrodite" was that true sex was determined by gonads. A person with testes is "really" male, even if she has breasts, labia, clitoris, and vagina, even if she was raised female, wears dresses, identifies as a heterosexual female, and is married to a man. A person with with ovaries is "really" female, even if he has a penis, scrotum, and just won the Mr. Olympus bodybuilding contest. Only people with one ovary and one testis, or intermediate gonads, ovotestes, are "really" intersex. This rule is arbitrary and says nothing about our lived experience.

So I hate the "true" and "pseudo" terms for classifying intersex people. On the other hand, I, personally, don't object to being called a "hermaphrodite." I realize this is a very atypical position among intersex people. Most intersex people who are politically aware hate being called hermaphrodites because of the baggage the term carries. It evokes greek mythology, and we're not creatures of myth. It is used a lot by fetishists, who get off on the idea of having sex with a body that has breasts and a penis, and we're not volunteering to be sex objects for every kinkster out there. I agree that this baggage is a real problem. But I myself don't blame the term. I like that it shows how we've been around forever, and that in some societies, we've been considered specially blessed by the gods, rather than freaks.

In any case, I don't identify with the term "true hermaphrodite," and always put it in quotes. I'm intersexed.

Tuesday, May 12, 2009

Transphobia and Intersex Experience

I woke up this morning to a set of transphobic comments on my last blog post. Rather than mope (OK, I did mope, but rather than continuing to mope), I thought I'd use this as a teaching moment.

Transphobia 101

Transphobia is the disrespecting of people who are transgendered--considering trans people to be pitiable or disgusting or evil or deluded or just plain weird. It is usually expressed by cis people--those whose gender identity matches the sex they were assigned at birth. (Note that my definition of cis sex treats an intersex person assigned female at birth in the same sex category as a person with normative-appearing female genitals and gonads.) 


Like all biases born of privilege, transphobia assumes that the marginalized identity needs explaining while the privileged identity does not. For example, homophobia works this way. Homophobic people often ask where queer identity comes from ("How do you know you're gay? Are you sure? What made you gay?") without asking where straight identity comes from ("How do I know I'm straight? Am I sure? What made me heterosexual?") Transphobic people expect trans people to have to explain and prove our gender identities when they cannot do the same for themselves.

Transphobes usually assume that our transtitions are about them: that we are doing this to gain access to their spaces. The favorite bugaboo here is the idea of "a man in a woman's bathroom, horrors!" But the fact is that if some male-assigned creep wants to harass and assault women by peeping at them in bathrooms, he can just walk in and do it for free. To medically transition from male-assignment to female status, a person must invest thousands of dollars over a period of years, endure social stigma, violence, employment discrimination, etc.--and
be vetted by a series of medical professionals, all of whom are constantly ready to slam down the gate and stop the process if they catch any whiff at all of the transition being related to kink rather than identity. That's not a plausible route for peepers.

There is a transphobic double-bind that relates to how well trans people "pass"--that is, whether a trans person looks to observers like hir sex of assignment or hir sex of destination. When transphobes recognize a person as visibly trans, they mock hir: "Look! An ugly chick with mascara on her moustache HAHAHA!" or "OMG--dude in a skirt!" If they encounter a person they cannot assign to binary sex categories, they confront the person and demand a binary identification: "Hey! Are you a guy or a girl? What's wrong with you?" And if they take a trans person as their identified sex after a "successful" transition, and then discover the person is trans, they read this as deception, especially (it all being about them) as some attempt to sneak into their pants.

There are particular feminist-transphobic tropes as well. The second-wave feminist transphobic line is well-encapsulated by my morning commenter: "In case you forgot, the majority of transgender people are males to begin with. They still have their male power, male privilege, male upbringing and male experience. Even though they are trying to claim female, womanhood and female privilege, when in reality, they are still male."
This transphobic vision imagines a cabal of men whose goal in life is to infiltrate the Michigan Womyn's Music Festival by any means necessary. Trans men are the dupes of this cabal, as my commentator states: "[Y]ou have been taken and hijacked by the tranny (male) mentality."

There is a third-wave feminist transphobic alternative reading of trans people. In this vision, gender is not an essentialist dichotomy that cannot be altered, but a repressive socially-constructed binary that must be subverted to liberate people. (The language is very High Theory, I know, I know. . .) Here the "crime" in transitioning is subscribing to gender stereotypes and strengthening the myth of dyadic gender, opposite sexes. If you were female assigned at birth, not believing that you are "really a woman" is great, but believing you are "really a man" is regressive, unenlightened, idiotic. You should subvert gender and be genderqueer but not transition.

Intersex Transphobia

To many people, the fact that intersex people can be transphobes comes as a surprise. If you are born obviously neither male nor female, people reason, any identity you have must make you an ally of trans people. You could identify as intersex, which is a very odd thing to do since it queers dyadic sex, and which puts you (in their minds at least) in the same box with gender transgressors like trans people and genderqueers. Or you could identify with your sex of assignment, which usually involves surgical assignment, and so you should approve of people having surgery to live in the sex with which they identify. Or you could be assigned to one sex and identify with the (binary) other, in which case you are trans gendered by definition.

However, intersex people can be quite transphobic. The dynamic is very similar to that of lesbian, gay and bisexual cis individuals who hate trans people and blame homophobia on the transgendered: "When I came out to my mom, she panicked and thought it meant I was going to start/stop wearing skirts to church and humiliate her--it's all your fault!" Intersex transphobes believe that they are treated as freaks by society because society thinks they are trans people. They see trans people as making a perverse choice while intersex people's misfortune is biological and "not their fault." If they could just purge the world of trans people, society would finally be nice to intersex people. It's a sadly common dynamic in all sorts of marginalized communities: instead of uniting to fight oppression, people direct their anger at some other marginalized group they see as nastier.

Another way in which intersex transphobia emerges is in relation to a myth held by some trans people. That myth is the belief that society must be kind to intersex people (since it's a biological condition), which leads a good number of trans individuals to wish for intersex status. Society is not in fact so kind--take a walk in my shoes, please--and I empathize with interfolks being upset at the denial of our pain implicit when trans people want to claim intersex status. But this doesn't justify transphobia. Consider a parallel dynamic: in the 1980s a lot of (white) gay men and lesbians said "Society is fair to black people because it's biological and not their fault, so we need to find the gay gene so homophobia will disappear like racism has." This totally denies the pervasive continuing racism that African Americans face, and is stupid and wrong--but this fact doesn't justify homophobia.

My commentator of the morning subscribes to this practice, and taught me a new slur. Zie says, "You see intersex as a 'blame free' group. It's fairly obvious that your a trans and your just another one of those transjackers, who want to hijack the intersex community for your own perverted gain." Transjacker, woo. Well, I am trans gendered, but I am also intersexed, and I can't see how one can hijack oneself.

Who's Erasing Whom?

It seems that my morning commentor believes that no intersex person is trans gendered. Maybe zie is asserting that all intersex people identify with the sex they're assigned at birth. Or maybe zie means that whatever sexes intersex people are living in, and whatever medical interventions they employed to arrive there, this does not constitute "transitioning," and hence thay are not trans gendered. I'll quote what zie says:

"I also find that by you claiming that intersex has a link with trans, you are in effect erasing the history, upbringing and experience of those who are born intersex and intersex born intersex people. You are erasing not only my intersex experience, upbringing and history, but you are erasing every other intersex person's experience, history, and upbringing as well. So I hope you like what you did, by erasing mine and every other intersex person's shared experience, upbringing and history because you and every trans out their are doing that to women, lesbian and intersex people out their."

I thiink that my commentator believes that I was not born intersex. Either that or zie's saying that since no intersex people are trans, and since I identify as trans gendered, I am by definition (no longer) intersex. Whichever is the case, my commentator is projecting hir desire to erase onto me. Zie is saying I don't exist. I am not part of the "every intersex person out there" who is being destroyed by my saying that intersex and trans gender experiences have a lot in common.

I'm Not Going to Disappear

Sorry, my lived experience as a female-assigned-at-birth "true hermaphrodite" who is transitioning to somewhere on the male side of the spectrum is not going away.

My commentator says, "Their is no one within the science, medical and academic community who will back your warped logic and claim [that there is a linkage between intersex and trans experience]." Well, I am a professor, I study medical sociology, and I used to work at a genetics lab, and I can assure you that my commentator is incorrect.

The Moral of Today's Post

My conclusions are simple. Intersex people suffer from transphobia. Intersex people can be transphobes. And trans people who think that they'd be safe from bias if they had intersex status are sadly wrong. But none of that is going to stop me from speaking my mind.

Wednesday, May 6, 2009

Intersected, Transsected: The Intersex / Trans Nexus


A troubled alliance

Intersex and trans people share some deep common experiences. Yet we often find ourselves prickling at comments made by people in the "other camp." As an intersex person assigned female at birth and transitioning to legal male status, I consider myself both intersex and trans, and I'd like to speak to what both groups share, and what divides them. Divides us.

Commonalities

The most fundamental thing intersex and trans folk share is that we suffer because we belie the ideology that dimorphic genitals determine gender. This is the belief that people are born with one of two possible genital configurations, and that gender identity is inevitably bound to this genital configuration. Penis = "it's a boy!"; vulva = "it's a girl!"  This is an ideology so basic that most people in our Western society rarely if ever question it. Then we intersex and trans people come along and call a fundamental belief into question. Genitals come in a spectrum of possible flavors. Gender identities are not determined by genitals. We are girls born with penises, or androgynes born with vulvae, or boys born with both testes and a vagina. And we make people nervous.

Freaking people out when it comes to sex and gender turns out to have serious consequences. We evoke shock and horror, distate and tittering, fetishistic dehumanizing desires. People fail to treat us as. . . people. Doctors poke and prod us, employers find excuses not to hire us, and idiots bash us. So: we share a common enemy. We suffer from the enforcement of the ideology that dyadic genitals determine gender.

Another thing intersex and trans people share is that we have a difficult relationship with doctors who have power over our lives. For people with intersex conditions, this often starts at birth, when doctors label us as defective and in need of surgical "correction." We are subjected to sex assignment and "corrective" surgeries without our consent. Then many of us grow up not identifying with our sexes of assignment, and join with our trans siblings in facing gatekeeping from the other side. People who identify with a gender that does not match our sex of assigmnent often want to alter our bodies, to reduce feelings of tension, and to get other people to recognize our deep internal sense of self. And we face a lot of hurdles. Medical insurance generally doesn't cover sex transition services--and they are expensive. Worse, to get access to them we have to run a gauntlet of medical gatekeepers. We need psychologists and doctors to grant us access to the hormones and surgery we want, and they make it hard for us, very hard. At every step we may find ourselves confronting, if not outright bigotry, a strange assumption that to want to do what we want to do, we must be mad. We have Gender Identity Disorder, considered a mental illness. Gatekeepers act as if we might well be utter psychos, and need to be tested, cautioned, challenged, as if anyone decides to face discrimination and violence on a whim.

Another thing trans and intersex people share is the way in which we are sexualized in a society with both Puritan and Dionysian strains. This is complex enough to rate its own post, so I'll set it aside for now.

Tensions: Intersex Complaints

Something that makes a lot of intersex people grouchy is encountering trans folk who think we have it easy. There's a belief some trans people hold that doctors and people on the street are understanding of intersex people's needs. More particularly, these trans people think that if they had an intersex diagnosis, they'd get easy access to medical transition services, and have their transition honored by employers, schools, the DMV, and other institutions.

But this is not the case. Doctors and families make decisions on behalf of infants with visible sex variance, and having subjected us to surgery without consent, they don't want to hear that we're ungrateful. As for schools and employers and DMVs, we have the same relationship to them if we want to undo a sex assignment that trans folk do when they seek sex reassignment.  Intersex people are not "fast-tracked" in medical or legal gender transitions.  Our transitions are not paid for by insurance--only those medical procedures that would make our bodies conform to our assigned sexes are covered.  In fact, intersex people can face higher hurdles in dealing with diagnostic gatekeeping, as the GID diagnosis used by psychologists to green-light a transition is understood by some as excluding intersex people.

Nobody wants to hear their suffering dismissed. Intersex people feel hurt when trans people treat living with intersex status as a walk in the park. It is true that *some* doctors and families and coworkers are more comfortable treating intersex people as tragic victims than they are when they look at trans people and see them as having "chosen" to be freaks. But it's not true of others.  And it doesn't make accessing transition services any easier.  Furthermore, treating intersex people as "lucky" glosses over all that intersex kids often suffer in childhood, with multiple surgeries, humiliation, and familial silence.

Another thing that bugs intersex people is when trans people try to latch onto intersexuality as a way to explain their identities. This is especially common among people just coming out of the closet. Trans folk who've been living in denial and are reaching the point where they can't bear it any longer often search the internet, find one of the few intersex support sites, and start posting about how they must be intersex: "I must have some intersex hormone imbalance--I hate sports and cry easily." "People have told me my clitoris looks kind of big and I want to have sex with girls, so I must be intersexed." It makes it hard for intersex people to use the boards at times. Interfolk get tired of explaining the difference between intersex conditions, sexual orientation, and gender dysphoria to nonintersex people who are looking for an explanation for trans identities..

Tensions: Trans Complaints

Trans people are less likely to feel irritated by intersex people's actions, because they usually aren't aware of meeting any. Intesexed people are instructed from youth to go stealth, and we're often invisible. But there are legitimate gripes that trans people can have with intersex folks.

Intersex people can be transphobic.  Intersex adults who identify with their sex of rearing and don't want anyone to question its legitimacy can reject people of any bodily configuration who are interested in transitioning. Intersex people who want to transition can consider their need more justifiable than the need of trans people born with more normative genitalia. This is wrongheaded, wronghearted.

Just as genderqueer intersex folks get irritated by trans people who hold to highly dyadic, sex-sterotyped gender ideologies, genderqueer trans folk can find stereotypical dyadic gender presentations from intersex people very disappointing. They feel that if anyone should be enlightened about the force of gender-regressive ideology, it should be intersex people. And I can certainly understand why genderqueer trans people, suffering the slings and arrows of social bias against androgyny, would want intersex people to identify outside the gender dyad. But genderqueer trans people should have empathy for the fact that the majority of intersex people do identify with a binary gender category. Given the extraordinary pressure intersex people are under to genderconform--from the medical profession, their families, even intersex advocates, above and beyond the social pressure everyone faces--genderconforming presentations are unsurprising. And everybody's gender identity deserves respect, whether it aligns with sex of rearing, against it, or ourside the binary.

Alliances

As an intersex person who is transitioning, I see clear common cause between inter- and trans folk. Many intersex people deal with transition, and live as a bridge between the inter-cis and the nonintersex trans community. Those I've just termed the inter-cis--people with intersex conditions who identify with the sex assigned to them at birth--could gain support and community if they'd come out of the closet and identify as siblings of people who sex transition. Intersex advocates could gain the support of a large pool of trans people and work together on a general campaign for the individual right to choose to use or avoid medical intervention in sex characteristics ("My body, my sex, my right!"). Trans people could gain allies whose very existence undermines the genitals-determine-gender ideology that binds people.

There are issues to address. Intersex transphobia and trans jealousy of mythic intersex advantages in transition are both highly problematic. But our commonalities far outweigh our differences, and we should be allies.

Tuesday, April 28, 2009

Intersex 101

What is intersex?

OK, it's important that I get the basics out for blogreaders unfamiliar with intersex conditions. In our society, it’s common to think that all people are born either male or female. But the biological truth is that sex is a spectrum. It’s typical for people to lie near the male or female ends of the spectrum, but many people are born with bodies closer to the middle. Sometimes this fact is immediately clear at birth, because a baby has intermediate genitals. Sometimes a person may look male or female on the outside, but have different internal organs than would usually be expected. And sometimes a person may have a body with typical female or male organs, but have chromosomes that do not match expectations.

How common is intersexuality?

About 1 in 1000 babies are classified at birth by doctors as intersex because their genitalia appear atypical. This is more babies than are born with Down’s Syndrome. Many more babies are diagnosed as having a "disorder of sex development" based on variant genitalia, yet not given an "official" intersex diagnosis. Other individuals are not diagnosed at birth, as their genitals appear fairly standard, but later are found to have an intersex condition. It is commonly estimated that 1 in 150 people has an intersex condition. Some find out because they encounter fertility problems, or have a medical scan done for some unrelated reason. Some people never know--do you know if your chromosomes are XX, XY, XXY, or some other variation?

What is the gender of an intersex person?

The way to tell the gender of an intersexed person is to ask them. Often intersexed people identify as either male or female, because that is how contemporary Western society understands gender. Some of us do not identify as male or female, however. You can’t tell by looking at an intersex person’s body what their gender identity will be—different people with similar looking intermediate genitals will have different identities. Simply respect each individual’s sense of self.

What are central concerns for intersex people?

Intersex status has been treated as a source of shame in the U.S., which means that most intersexed people are in the closet about their status. We have been called “freaks” and “monsters,” have been treated as sexually titillating, have been excluded from international sporting competitions, and have been subjected to medical treatment without consent. Intersex people deserve to have their bodies, their gender identities, and their choices respected.
A major complaint of many intersex people is that they were subjected to childhood surgery that they are unhappy about. Every day in the U.S., dozens of babies are surgically altered to “correct” intermediate genitals to look more typically female or male. Doctors choose the sex they see as appropriate for the infant based on appearance or surgical ease—and often, their choice is wrong.  Furthermore, although doctors say they have gotten better at these surgeries over time, they often result in loss of genital sensation. I don't know about you, but I and many others would rather have sensitive genitals than somewhat-more-average-looking ones. Advocates for intersex people urge that no sex assignment or cosmetic surgery be performed on children. Instead, intersex children should be allowed to grow up to make their own decisions about what surgery, if any, they would like.


The decision about a sex of rearing for an intersex child is often rushed.  This is because families are only given a day or two to decide whether to put an "M" or "F" on the birth certificate.  What intersex advocates urge is that the requirement of listing a sex on the birth certificate be removed.  After all, in most states in the U.S. doctors used to be required to list a race on the birth certificate, but that requirement has been eliminated.  The reason given for listing a sex--that it would help to identify an infant who was lost or abducted--is very weak.  Footprints which are taken at birth are vastly more identifying, and in any case, the family can give authorities information about the sex, race, hair color and other information about what a child looks like without it being listed on a birth certificate.  So, removing the requirement of listing a binary sex of male or female on the birth certificate would not hurt anyone, and would give families of intersex children all the time they like to decide on a provisional sex of rearing.

Often, doctors and families try to keep chidren's intersex status a secret, even from the children themselves.  Knowing that there is something "wrong" with your body, but not what that is, is confusing.  Knowing that your body is sex-variant, and that this is something that must be kept a secret from others, leaves a person feeling ashamed and isolated.  Advocates ask that children be informed about their bodies in a nonstigmatizing way.  Having a body that is atypical can be seen as special--think of how our society celebrates having red hair, another atypical bodily status.  

Sometimes an intersex child may be happy living in an assigned sex, but then experience bodily changes at puberty that are atypical for that sex.  For example, an individual born with a typical-looking phallus but internal ovaries and a uterus will develop a menstrual period.  If that child is happy being raised as a boy, he may find this difficult to deal with.  In that chase, the child should be given access to hormonal treatments to prevent menstruation and promote a typical male puberty.  If he wishes it, he should be given surgery to remove his ovaries.  The decision should be his, and if he is comfortable leaving his body unaltered, that should be the course of action, and he should be supported in his embracing of his sex-variant body.

Intersex people may suffer from gender dysphoria if they were assigned by doctors to a sex but do not identify with it. If so, they should be assisted in securing hormonal and/or surgical treatment so that they can transition to the sex that is the same as their gender identity, if that is what they wish.

Intersex people and their families may also need supportive therapy. When a mother gives birth to an intersex baby, the family may be thrown into distress. It is especially important that the family receive support so that hasty decisions about “normalizing” surgery are not made. Adults who discover that they are intersex may also be thrown into an identity crisis and need support. And since all intersex people have to face lack of understanding and pressure to hide our sex status, many of us need access to counseling.

There is a myth that intersex people are almost always infertile.
Sadly, many of us are infertile not because of how we were born, but because of surgical intervention in infancy. In fact, intersex people can have children (I did it. . .), but we may need fertility treatment and supportive medical assistance during pregnancy and birth.

What are some common types of intersexuality?

There are many conditions that lead to intersex status. I have no interest in getting overly clinical and showing the sort of medical photographs of dehumanized children with their genitals exposed that are so common in discussions of intersex. We are people, not . . . bits for display. However, I'll do a quick run through of some of the diagnoses given to intersex people, with physical description, in the name of education.

People with Complete Androgen Insensitivity Syndrome usually have a clitoris, labia, and partial vagina, with testes internally. They develop breasts at puberty, but no periods. People with Partial Androgen Insensitivity Syndrome are born with intermediate genital appearance and internal testes.

People born with Congenital Adrenal Hyperplasia or CAH are born with a phallus of average or small size, an empty scrotum, a uterus, and ovaries. At puberty, people with CAH will develop breasts and get a period.

Hypospadias refers to a range of conditions in which a person has phallic tissue, but does not have the urethral opening at the tip. This can be a small displacement in an otherwise typical penis, or can occur with an intermediate genital appearance.

People who have Klinefelter Syndrome are born with XXY chromosomes. Individuals with Klinefelter’s usually have a penis and small testes, wide hips, small breasts, and are usually tall and long-limbed.

People who have ovotestes are diagnosed as "True Gonadal Intersex" by doctors. Ovotestes are gonads which combine ovarian and testicular elements. Those of us with ovotestes may also have an ovary or a testis, and may have a uterus and a menstrual period.

What can other people do to be allies for intersex folks?
There are plenty of things allies can do, and I'll post more about them later. But the single most important thing allies can do is to refuse to treat intersex status as something shameful and freakish. Allies can help educate people about the fact that intersex happens and is not some sort of medical emergency requiring cosmetic surgery on infant genitals. Only an intersex person can determine what hir gender is, and what surgery if any zie wants--doctors and parents can no more decide what gender a person will have than they can pick hir sexual orientation or taste in music. Educating people about this will help lead to a day when parents welcome an intersex baby as a happy rather than tragic addition to the family.

Sunday, April 26, 2009

Intersex Roadshow: A Personal Introduction

Intersex by birth, honest by choice.

I'm Cary, and my sex is neither male nor female; I'm intersexed. I was born that way. Because my nonstandard set of parts included an ovotestis, which is a gonad that's in between an ovary and a testis, I'm classified medically as a "true hermaphrodite." But doctors don't get to decide who I am.

I'll explain more about the sorts of bodies that get one classified as intersex in a later post. I'll also go into more detail about how we get treated by doctors, institutions, families, and people on the street. The simple story is this: we live in a society that acts as if there are two sexed flavors of people--male and female--but reality is more complicated and more interesting. Intersexed people are all around you, though often you'd never notice us. We live in a culture that treats intersex status as shameful, and most of us born this way have been told all our lives to hide it. I'm not hiding anymore.

I am not defective. I am not disordered.


It is a simple fact of nature that sex is not dyadic, not black-and-white, not limited to two categories. Real bodies come in a rainbow of possibilities. But our medical establishment today insists on allowing for only two, male or female. Intersex conditions are deemed "birth defects" that must be "corrected" surgically, as soon as possible--even though the surgery leaves us with scarred genitals that don't look typical and have limited or no sensation. The idea is that somehow the surgery will make us have "normal" identities as men or women, and that this is vital for everyone's wellbeing.

The power of the medical establishment is so great that what limited intersexed advocacy there is focuses on doctors. The aims of advocacy are basically two: one, to stop infant genital surgery, and two, to get access to medical resources to undo earlier medical interventions. To try to reach these goals, our advocates have been forced into bizarre postures. Again, I'll explain more in a later post, but in brief, doctors dismissed intersex advocates' calls to end infant genital surgery, saying, "What?! You want to keep us from doing surgery so these poor infants will grow up to be some third-sex intersexed freaks? Never!" To placate the doctors, these advocates said, "Oh no! We just want to delay surgery a bit, but we'd never want people to grow up to be unsexed freaks! In fact, we'll never use the name 'intersexed' again. We're just people with Disorders of Sexual Development who are a bit miffed because you cut off the parts we wanted, so please give us more surgery and hormones so we can be normal men and women living with well-managed DSDs."

Well, I am not defective. I am not disordered. I am an intersexed person. And if both doctors and people who speak in my name recoil in horror when I say that I don't indentify as a man or as a woman, too bad for them.

United we stand.

A couple of years ago, something happened to me that changed my life: I met my partner, Beta. I was doing research on embodiment in virtual worlds and was interviewing people with gendertransgressive avatars. In the course of interviewing Beta, I found myself in the presence of someone smart and appealling. . . and openly intersexed. As I've said, most intersexed people have been well-schooled in stealth, so this was a rare treat. One of the joys of having Beta in my life is how things that seemed implausible in isolation became possible in tandem. Like coming out, and being honest about my birth status, or using neutral pronouns (like the pronoun "ze" instead of "he" or "she"). Like being able to assert my masculine gender identity, my intersex sex status, and a femme flair to my style of gender expression all at once, unapologetically.

Lots of people live genderqueer lives, though it' not easy for anyone, given the gender role policing commonplace in American society. Oddly enough, though, it's particularly hard for an intersex person to step outside the confines of dyadic gender, and it wasn't until Beta entered my life and lent me hir support that I was really able to do it myself.

Don't fence me in.

Something that really frustrates me is hearing advocates tell the world that "real people with DSDs" almost always identify as male or female and conform to gender norms. They say that exploitative academics want to use the idea of intersex to subvert gender, against the wishes of "real people with DSDs." They say, "Of course we have nothing against transgendered people who don't want to go all the way and like confusing others with their odd gender presentations, but really. . . people with DSDs are usually quite happy with normal male and female labels."

I was female-assigned, female-reared. I never identified as a "real woman" and wanted out of that box, but it just seemed implausible for me to do anything about it. When you're facing not only the usual transphobia, but the voice of Intersex Authority saying you shouldn't attempt to escape the dyadic gender boxes, it's hard. All I can say is that when I finally, finally came out, it was such an extraordinary relief.

So, I'm an academic, and I do think acknowledging intersexuality presents a strong critique of dyadic gender ideology. I'm not going to keep quiet about that just because it freaks out doctors with regressive gender beliefs. I am profoundly concerned that those doctors are performing lifealtering cosmetic genital surgery on unconsenting infants, but I don't think my keeping silent and closeted helps matters.

The intersex roadshow. . .

What I think will help is just the opposite. I want to take my intersex, androgynously masculine, gendertransitive self public. I want to talk about things I've been thinking about for many years, personally and academically. I want to reach out to my intersex sibs, and to genderqueer folk, and to thoughtful, interested people of every stripe. Hence this blog . . . Hope you enjoy.