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.

19 comments:

  1. I think I should comment on your profound reasons for the drawing and everything that you've said (including icky Dr. sayings). But honestly it's the artist in me that is responding most strongly to this post. This is an aesthetically beautiful image. The line between illustration and abstraction is perfect. The painterly effect is lovely and the colors are my favorite! Well done!

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  2. Jubilant, I'm so happy to hear you say that. I worked hard to produce something easy to read, yet nonclinical and warm. The affirmation is very much appreciated.

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  3. That truly is a lovely picture! And yes.. even I know someone who doesn't even look the same as that. Makes me want to draw one as well.. Just to show more examples- so no one will be left out.

    Hmmmm.. ^^

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  4. Heh, we're like snowflakes. Seriously, Claude, if your friend is comfortable with you doing a life drawing, maybe we really could start up an art/education site. I think anonymity would be important for most models, and the power to approve the artist's final image.

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    1. Please do create a gallary! Thank you so much for doing this picture. I was just googling because I want to understand but know nothing, and felt images might help me understand more. There is something very powerful about images in discussions of gender. Just as Tee Corrine's "Cunt Coloring Book" (pen & ink portraits many varied female genitalia) had such an impact, by showing what was previously either unseen, or otherwise seen in purely medical or purely pornographic terms.

      Art is a powerful way to tackle this. People need to SEE in order to understand. So how can that be done without being abusive or voyeuristic? As you have done it here.

      I hope you do start a gallery. Perhaps some would contribute self portraits.

      As a woman who's gender has never been ambiguous, I came here to try & understand. Just seeing your one picture here, the beautiful symmetry of this person's natural form, and reading your post has made me an instant advocate for intersex rights!

      A picture speaks a thousand words.
      thanks.

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  5. This is a really nice post. :)

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  6. Perhaps it would interest you to take at look at my website: www.123hjemmeside.dk/gender_testing

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  7. Hi, Anonymous. Thanks for preparing that comprehensive overview of the (mis)treatment of intersex athletes.

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  8. Late comment, but maybe someone could start up an art/education site. It couldn't hurt.

    (Claude, Eunis, etc.)

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  9. I was playing games online however for reading this post more interesting thanks for the share please do keep it going great job....Loveing this.

    Cheers,
    ___________________
    victor
    Online Marketing of your brand

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  10. Myself, I agree that such a site would be a most excellent idea.

    Victor, I'm so glad you came across the post by accident and loved it.

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  11. thanku for such a wonderful imformative work ,im also intersexed im yet to find out my true condition,thanku u make me strong too face the world again thanks wendy

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  12. Very well expressed, I am married to a man who has fought this struggle all of his life and I find your tenderness in expression and drawing to be well thought out and very clear. Thank you for the strength to do this site.

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  13. hi my is ariel f im a intersexual born both male an female im internal female outside male im so glad that there peole who care about us arielf42@yahoo.com help me

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  14. hi my name is arielf im a intersexualborn both male an female im internalfemale on the inisde but all male on outside i thank u what about the pic arielf42@yahoo.com

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  15. knowledge is power,I had no idea that intersex was so common and believe God makes no mistakes, and you are lending strength to a whole lot of people. I'm not intersex but want everyone that is to know that not everyone will judge you. You are just like the rest of us, we are all God's children in the begining and end sending prayers and strength to anyone who struggles and my best regards to all who are happy.

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  16. I've always Known that I was born as a intersexual person
    How ever,I was born both male & female ..Both inside & out
    Thank you for the beautiful website & drawing
    My sister is in denial about my condition
    ( sure she changed my diapers dyuring my infancy.... But that doesn't mean that she 's right)
    I have one question though.. can a female intersexual still have a regular period?

    Andraste

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  17. I am a true hermorphidite, and hermorphidites have to have both the ovaries and testies. This may or may not be a hormorphite. It is the sex glands that develope the male or female characteristics. The testies may even be on the inside and have a normal vaginia on the outside or have a normal penis on the outside and overies on the inside. It Bothers me alot that people think this is hermorphaditism. The sex organs mean nohing and the sex glands controle everything! Blood, bones, mood, intellect, ability to fight disease! People need to do more resurch before they write an article like this. In fact this picture is the most common of all misconceptions, as most true hermorphadites are actualy normal in appearance from the outside. This picture is most commonly a birth defect and not true hermaphordism!

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