Friday, December 3, 2010

Do I Have the Right to Marry Anyone?

On Sexual Identity and Intersex Experience

I'm married. I wonder if I'll be sent to jail.

DOMA, the Defense of Marriage Act, states that the U.S. federal government defines marriage as a legal union between "one man and one woman." My home state of Wisconsin goes further, providing that residents other than "one man and one woman" who go out of state to marry can be fined up to $10,000 and/or imprisoned for up to 9 months.

My spouse and I got married out-of-state.

The law scares me--because I'm intersex by birth.

My spouse, for whom I thank my lucky stars, is also intersex. We have very different bodies, different "conditions," but we share key experiences that bind us closely. And one of those shared experiences is a constant feeling of unease with regulations and categorizations--marriage laws, for example. If you were born neither male nor female, and you were looking at laws banning marriage unless it joined "one man and one woman," how would you feel? Unacknowledged, uncomfortable, socially unmoored? The people who wrote these discriminatory marriage laws had other aims--the existence of intersex people probably did not cross their minds when they were putting the bills together. But that's how a million regulatory regimes impact us. You are required to declare a dyadic sex, supposedly to protect your identity or serve your needs. That's why you have to check off an "M" or an "F" box to get a driver's license, or open a credit card account, or fill in a Facebook survey. True, these checkboxes conflate together physical sex and gender identity. I'm intersex, but my gender identity is masculine, so I can just check the "M" box on the Facebook survey about blue jeans.

But marriage is different. There's an inquiry into your "true sex"--supposedly to protect society at large.

The furor focuses on "same-sex marriage."

Conservative opposition to "homosexual activism" is what has driven the enactment of DOMA and the 29 separate state laws limiting marriage to "one man and one woman." I'm sure you're familiar with the rhetoric, which tends toward Biblical one-liners: "Male and female created He them;" "God created Adam and Eve, not Adam and Steve." There's the constant quotation from Leviticus, "
You shall not lie with a male as with a woman. It is an abomination" (with the constant nonquotation of other passages from Leviticus, like the prohibition against wearing fabric mixing linen with wool, or eating pork, or trimming one's beard).

According to this simplistic interpretation of the Bible, God made men and women to be opposite and distinct, intended for procreative marriage, with a husband leading the household and a wife practicing submission to him. Heterosexual marriage based on these principles is said to be the foundation of society. Straying from it, we are warned most stridently, will undermine both morality and social order.
Advocates of same-sex marriage have written many eloquent defenses of allowing gay- and lesbian-identified couples to wed. I certainly agree with them that male couples and female couples should be able to marry.

But where do I fit in this picture, as an intersex individual?

Last year I had a conversation with the leader of a proselytizing Christian group that had taken over the central plaza on my college campus. They were holding up signs saying that any sex outside the context of a marriage between one man and one woman damned a person to hell. I'll give them this: they were coherent in their sexual beliefs. They were also holding up signs about masturbation earning one eternal damnation (an assertion that did not win them a lot of converts in the college audience).

I stepped aside with the leader, and asked him respectfully what his religious precepts would advise for me. I explained that while I lived as a man, and he saw me as one, I was born with an intersex condition and was assigned female at birth. Since I was neither male nor female, how was I to follow a command that marriage only be contracted between a man and a woman?
The religious leader stared at me for a bit, then rallied. He said that he wanted to tell me that he had great pity for me, and that God did not intend that I be born intersexed. "Birth defects," he explained, "exist because of Adam's fall. Original sin warped God's creation, and that's why tragedies such as the birth of a baby with crippled legs or like you occur." He explained that when Jesus came again, all of this disorder would be purged, and there would be no more people like me. I mustn't be angry at God but at sin for putting me in my position.

I told him that I believed that I was born exactly as the universe intended, and was not angry at God. What upset me was how I was treated by my fellow human beings. In any case, given that I did exist as an intersex person, whom did he believe I was permitted to marry?

He asked me what the doctor had put on my birth certificate, and I said "female." He gave me a grave face, and told me, "I'm sorry, but then that is what you are. You may look like a man but you are not, and you can't marry a woman. It's like the case of a transsexual, even though it is not your choice." So, according to this religious leader, sex assigned at birth governs marriage law, and there can be no sex transitions, for intersex people or for those born with normative genitalia. (Nonintersex trans people get the extra distasteful twist of the lip for a "choice," but the end result is the same.)

I then asked the religious speaker if he thought I should marry a man. He looked very uncomfortable and just shook his head. I said, "So you don't think I can marry anyone?" He suggested that I dedicate myself to God's will and eliminating sin rather than dwelling on my personal situation.

I guess that's what monks and nuns do: dedicate themselves to God, and live a life of celibacy. And since he didn't think I could marry anyone, and sex is only allowed in marriage between a woman and a man trying to procreate, celibacy is what he felt God required of me.

In the parlance of my Jewish ancestors, Feh.

I did ask him one more thing: why did he think that the doctors had picked the "right" dyadic sex for me? Couldn't I be trusted to look into my heart and know myself better than they? He just said that doctors are the ones who know, because they have the technology and the tests.

I don't know when or how doctors became the oracles of divine will for good Christians. In fact, I'm sure that when doctors declared that masturbation was healthy, the members of the group I encountered rejected that promasturbation prescription vehemently. . .

The majority of Americans would see the group I encountered as rather extreme. Yet the majority of Americans have enacted marriage laws that reach the same conclusion for intersex people: marriage is only acceptable between a "man" and a "woman." The fact that I'm neither by birth is some sort of unfortunate, bizarre accident. Doctors can be relied upon to pick the right sex for intersex babies, and that should clear the whole problem up.

But even doctors aren't so sanguine.

Doctors warn of a "risk of homosexuality" for babies born intersex.

Yes, you heard that right. Just read about some "DSD" or other and you'll see it there. Take congenital adrenal hyperplasia, or CAH, which is often manifested in the birth of a child with a penis outside and uterus and ovaries inside. Medical texts regularly state that "even with surgical and pharmacological treatment, CAH girls are at risk of homosexuality." In fact, there is now a highly controversial prenatal treatment program led by endocrinologist Dr. Maria New, intended to influence genital growth in CAH XX infants, so that they're born looking more like a typical female--and it is being reported not as an attempt to prevent intersex births, but as an attempt to "prevent homosexuality." You can check that out here. What a confusion of intersexuality and homosexuality! (And how eugenic. . .)

I have to ask you, from the perspective of birth sex, how can an intersex person be homosexual--unless they only have sexual relationships with other intersex people? Of course, birth sex does not dictate how sexual orientation is experienced . . . but doctors misapprehend how this works.

What the doctors really mean with regard to children born with XX, CAH is this: they take babies born with what are often totally average-looking penises, but internal "female" organs, and they cut their penises off. (The call this "clitoral reduction" nowadays.) They prescribe the children testosterone-suppressant drugs. They tell their parents, "See, you have a girl!" But the parents know the children are intersex--they saw them born with phalli. The children know they're intersexed--they bear the scars, they take the daily meds, and are forced to show their genitalia to doctor after doctor. Of course these children often grow up with gender identities and behavior that differ from "normal girls."

Apparently we intersex people often freak doctors out once we're not cute little tots over whose bodies they have vast power. They take an intersex baby with CAH, give hir sex assignment surgery, and want to believe that having sculpted a vulva-shape in hir flesh they'll have guaranteed hir a future of "normal womanhood," stereotypically defined as involving no great interest in sports, but lots of interest in fashion and boys. Sometimes their patients grow up into the pink feminine heterosexual icons of the doctors' imagination, expressing nothing but gratitude for the removal of those embarrassing "pseudophalli."

And sometimes CAH intersex patients show up in the doctors' office as depressed or angry teens in short hair and jeans. Maybe they identify as male, or as genderqueer, or as tomboys--doctors don't seem to ask about gender identities or if anyone wanted to keep that penis they had been born with. What they do ask about is sexual activity, and if the patients are involved with boys or girls or both.

The data they collect is pointless.

Without knowing gender identity, you can't tell someone's sexual orientation. Take two people with the same CAH bodily configuration, and one can grow up to identify as female and the other as male. If a person identifies as male and only wants female partners, his sexual orientation is heterosexual. But the doctors will label this person "homosexual," because they assigned him to be female, and they don't ask if that's the gender identity he actually grew up to have.

Doctors are acting just like the Christian sectleader I spoke with at my university. Intersexuality is a mistake, they say, unintended by nature. Doctors have the godlike power to divine the "right" dyadic sex for intersex babies, and correct their faulty bodies. And the "normal" thing for these intersex children to grow up and do is to marry a person of the sex other than the one the doctors picked for the child.

What does this all mean for me?

My spouse and I were both born intersex. I was assigned female at birth, and she was assigned male (I escaped surgical intervention but she was surgically misassigned, to her lifelong regret.) According to the sexes doctors put on our birth certificates, we are a "heterosexual" couple, though we share a physical status. Had we both grown up to identify with the sexes we were assigned, our intersexuality would be invisible to society--as both doctors and Christian antigay activists would wish it to be. We could have married and disappeared into the suburbs. Biologically speaking, we would not qualify as "one man and one woman" for marriage, but nobody would ever have raised a stink, so long as we accepted our lot and kept quiet about our birth status.

But we did not identify with our sexes of assignment. Eventually, we both found the strength and resources to enter the gender transition process. This has come as a great relief to us both, though it hasn't made our lives easy (read my last post to hear more about that). If transphobia were not the huge barrier that it is, and gender transition services could be easily accessed, and insurance covered the medical expenses, and the legal hurdles weren't so high, my spouse and I could have done a simple if ironic do-si-do and would now be married as a man and a woman.

Gender transition being the long, drawn-out, expensive, legally-convoluted process that it is, however, according to our birth certificates, we're both "male." No matter that my spouse was never biologically male. No matter that she has breasts and gets a menstrual period. No matter that she has identified as female since the age of 3 or 4. No matter that her driver's license reads "F."  Because she already had genital surgery in infancy, and is considered a "poor candidate" for further surgery, and wouldn't want it in any case, given the sensation she already lost in the first round, she can't change her birth certificate, and in Wisconsin, sex for marriage purposes is based upon birth certificate sex.

So: one thing we're dealing with now, despite the fact that we live as a married man and woman, is we are currently, according to our birth certificates, in a same-sex marriage. At the time we got married, my legal documentation still listed me as female, so getting hitched was unproblematic--but at the moment we look different on paper. And since we went to San Francisco to get married, someone could now threaten us with that $10,000 fine and/or 9 months in jail Wisconsin law allows. We share this unhappy situation with other LGBT couples in Wisconsin who found routes to marriage, and I have great sympathy for them all.

Even if we were able to change my wife's birth certificate some day
, and we're no longer a same-sex couple on paper, we won't be safe. Because we're open about having been born intersex. Because we gender transitioned, and people know that. Because we're visible, we'll always be vulnerable to harassment by some bigot who wants to argue we're not "one man and one woman" and try to invalidate our marriage.

Intersex people having to deal with marriage restrictions is not some abstraction or game.

It's nervewracking stuff, and it's my lived experience. Sometimes well-intentioned people who want to construct arguments against "same-sex marriage bans" bring up the idea of intersex people like some sort of abstract theory. Take, as just one example, this post entitled "Common
Arguments Against Gay Marriage." A section titled "Hermaphrodites" poses intermediately-sexed bodies as a hypothetical and asks how "feminized" a "hermaphrodite" must be to be permitted to marry a man. The blogger gets excited about this just-so story, and states, "This is a type of sorites paradox. Traditional sorites paradoxes involve asking how many grains of sand you have to remove from a pile before it stops being a “pile,” or how many pounds a fat person has to lose before they are no longer “fat.” These are paradoxes because they involve characteristics which are vague — it’s not clear where a pile or fatness begins and ends."

Yes, this hypothetical of the Incompletely Feminized Hermphrodite follows the slippery slope, sorites paradox argument format. But we are not mythic creatures in some ancient Greek story Zeno might tell of arrows that get halfway to their targets. We are not some illustrative fable. In writing about intersex experience and one-man-one-woman marriage limits, I have to raise this issue, because I know there are other intersex people who are livid at how people who are supposedly our allies treat us--so angry that they think the intersex community should refuse to enter public discussions about how marriage restrictions affect us. I agree that we have been treated rudely, our bodies seized upon as fodder for arguments by people ignorant of our painful real life experiences. It's depressing.

the fact that our lives have been appropriated by others should not silence us. And so I am speaking out, and asking for something simple.

I am a human being, and I ask for respect.

All bodies deserve respect. Intersex variations are not lusus naturae, medical defects, the wages of sin, or mistakes unintended by God. Sex is a spectrum by nature, and everyone's body is a gift.

All loving relationships deserve social support. To believe that it is ungodly of me as an intersex person to get married to a man or to a woman because the sex I was assigned at birth did not match the gender identity I developed--that is a failure to understand and embrace a God of Love. To grant or deny people the right to marry based on their sex or their gender is simply wronghearted. All people--straight and queer, trans gender and cis gender, intersex and dyadically sex-normative--should be treated with dignity when they commit to love.

For a person to be threatened with imprisonment for daring to marry . . . now that is moral evil.

Wednesday, October 20, 2010

Does It Get Better?

This post is intersex-related, but is more broadly addressing LGBTI issues that arose in conjunction with Wear Purple Day events in the U.S.

On October 20th, thousands of Americans wore purple as part of the campaign to show support for young people who are being bullied because they are perceived to be lesbian, gay, bisexual, transgender or intersex. I am grateful to all of those who put on purple as a show of solidarity. Thank you for caring and for making this gesture of support. In the homophobic and transphobic cauldron of many American schools, large numbers of LGBTI teens are driven to despair, and some to its ultimate expression in suicide.

The Wear Purple Day campaign is affiliated with the “It Gets Better” project, in which adults record video messages to LGBTI teens to tell them that while they may despair now, they should keep hope alive, because life will get better when they get older. This too is a project that is well-intended, and I appreciate all the people who have made and contributed videos intending to support our youth.

But there is a problem with the framing of the “It Gets Better” project. Living with homophobia and transphobia does not magically disappear when one is handed a high school diploma. The title of the project implies that dealing with harassment and disrespect and violence is a phenomenon of childhood, as if “kids will be kids” and act immaturely, so we just need to wait it out and things will be fine. It focuses attention on the victim’s “not giving in” to mistreatment—which frames despair and depression as a sort of failure of the victim’s spirit, as weakness. (Notice that it is not a video campaign entitled, “Don’t Be a Jerk” aimed at homophobic, transphobic bullies.) It tells us to “be strong,” and we’ll be granted the prize of acceptance and respect when we grow up.

And that, I’m sorry to say, ain’t necessarily so.

There have been some dramatic incidents of anti-LGBTI violence against adults in the press of late. I think especially of the brutal homophobic beating and gang rape with baseball bats of three gay men in New York this month. These incidents are horrible and we must decry them. The possibility of being subject to such hideous attacks keeps many LGBTI people living in fear. But to focus our attention on hyperviolent acts like this directs the public eye away from the more quotidian experience of disrespect and veiled threat that many of us live with every day. While the number of us who will be gang-sodomized, let us pray, is few, thousands upon thousands of us continue to face, as adults, the sort of sneering and bullying that are common in high schools. And we too suffer low self-esteem, depression, despair. It is this that I want to address.

For some of us, being LGBTI in America today is not that bad. Those who are white, and middle-class, and gender conforming, and live in major urban areas may feel pretty comfortable. Even those in this privileged group still have to deal with people nudging one another and tittering at times, with marriage prohibitions denying them benefits, and with the insecurity of never knowing when they’ll be treated with disrespect—at a parent-teacher conference, or at a tax-return preparation service, or at a gas station. Even the conventionally attractive, young, white, churchgoing, well-educated suburban homeowners among us, apparently iconic ideal Americans, are usually aware of being second-class citizens. To say that this group’s lives got better after high school may be true, but it’s sad for the definition of “the good life” to be, “Well, I haven’t been subject to constant fear of violence since high school.”

And that’s the privileged group.

Let us be honest. The LGBTI youth who are subject to the most bullying are the ones who are less privileged. A middle-class gay white male high school jock is likely to face less maltreatment than an androgynous, poor kid of color. If you are a feminine boy (no matter what your sexual orientation), you are at high risk of bullying. If you are out as trans gender, you are at high risk. If you are marginalized already because you have a visible disability, or you wear out-of-style secondhand clothing because you are poor, or you are one of the only kids of your race/ethnicity at your school, your risk of maltreatment is much higher. And sadly, this does not magically melt away when you graduate from high school.

I’ve been thinking about this a lot today because yesterday was not a good one for my family in terms of LGBTI mistreatment. So I’m going to share this story with you. My family is suburban and middle class and middle American. My spouse and I are white (though our kid isn’t), I’m employed as a professor, we own a house and we keep the lawn mowed. My spouse and I are both trans gender, but as a trans man married to a trans woman, we have privileges many trans folk dream of. Our lives are supposed to be in the “it got better” category. But we still live with daily trouble with antiLGBTI bias.

It was my spouse who suffered directly yesterday. She’s intersex by birth, was surgically assigned male as an infant, but knew by the time she was four that she did not identify with her sex assignment. Rather than reassigning her female, however, she was treated with years of "gender therapy" intended to change her gender identity to fit her sex of assignment. This involved requiring her to do a lot of pushups, play football, and be physically punished for crying and other "girly" behavior. The “treatment” did not change her gender identity, but it did make her childhood miserable. She was not able to begin to gender transition until she was a legal adult, and by that time, without medication to postpone pubertal changes from testosterone, her body had masculinized. Starting hormone therapy did not reverse changes such as her having grown to be 6’3” and broadshouldered. (Because she has uterine tissue, however, it did start her menstrual cycle, made awkward by the masculinizing genital surgery she had as a child.) As a result of her history, my spouse must live her life in a body that will forever be androgynous, and here where we live, in the supposedly polite Midwest, this means constant street harassment.

For those of us who are gender-transgressive in appearance, whether we have chosen to be seen as genderqueer or would like nothing better than to be able to be gendernormative, but must live with physical androgyny, harassment does not end in high school. Especially when we are read as androgynously male, we are the butt of endless jokes and the subject of constant hostile stares. All my spouse and I have to do is go to our local Midwestern Walmart, and it’s like the circus came to town. People stop, and stare, and shake their friends’ elbows, and point. Sometimes there’s a supportive smile, and sometimes people pay us no mind at all, but we can never go without some people snickering and staring. Walking around in our suburb, my spouse has had to deal with parents yanking their children away from her as if she were about to abduct them on her afternoon constitutional. If she goes out walking at night to avoid these encounters, the police often curb crawl in a car behind her until she gives up and comes home. Going out to a restaurant we have to listen to people at the next table have an open conversation speculating on our genders and asking one another what’s wrong with people today. Every trip to a public bathroom exposes my spouse to danger of outrage or violence or police intervention, so she rarely ever uses one.

Gender transitioning has in some ways made our lives infinitely better than it was in high school. Living in a gender one does not identify with, with a body that gives one gender dysphoria, is terribly painful. But we are not now free from maltreatment and harassment, and my spouse suffers daily indignities. I’m androgynous too, but since I grew a beard I have more “passing privilege” and am usually read dyadically male, at least from the front. Also, I’m only 5’2”, and my spouse at 6’3” seems to trigger in young men out to prove their masculinity a lot more competitive transphobia.

But it’s not just individual harassment we have to deal with—it’s institutionalized transphobia. Yesterday, my spouse went to see her doctor to get her prescriptions refilled. It was not a good office visit. First, the receptionist loudly called her “Ma’am? Sir? Ma’am? Sir?” in front of the crowd of waiting patients. Of course, she was then subject to a sea of stares while she waited. And then the doctor refused to refill her prescription for estrogen, because her cholesterol was at 201, a point above the “normal” range. So my spouse has suddenly had the rug pulled out from under her medical therapy—medical therapy that is vital to her wellbeing.

I respect our doctor a lot, but she has never had a trans gender patient before (that she is aware of). Her reference point for estrogen therapy is menopausal women getting HRT. With them, denying a refill as a goad to lower cholesterol might be a nuisance, but that’s not the appropriate analogy. This is more like taking a person who was suicidal and is now doing better on antidepressants, and saying “I refuse to prescribe you any more antidepressants until you quit smoking.” But our doctor has had no training in dealing with caring for trans people, a failure of our medical schooling, and doesn’t understand how vital hormonal therapy is for a trans person. In a way, the doctor acknowledged that the issue was her lack of training. She said that she could not in good conscience continue to prescribe estrogen for my spouse, but that she’d give her a referral to see an endocrinologist with more expertise in hormone therapy.

The thing is, there is no endocrinologist our doctor knows of with training in dealing with trans people. There is no such endocrinologist in our health plan. Our health plan, in fact, refuses to pay for any trans gender care, and even though my spouse is intersex, and gets a menstrual period, they say she is “male” because that was what was put on her birth certificate—yet another example of the way we as LGBTI people are failed by institutions. There is no LGBTI health clinic in Wisconsin that can take over care. So, suddenly, we are caught without appropriate health care and a ten-day supply of estrogen left in which to fight to get access to someone who will treat my spouse with knowledge and respect. I’m staring at the number of the endocrinology office the nurse gave us. I asked the nurse if she could inquire if anyone there had ever treated a trans person, and she just sputtered uncomfortably and told me I could do that if I wanted to.

Would you want to be referred to a doctor who had never treated anyone like you, not knowing if that doctor in fact thought that people like you are “sick” and treating your condition a mistake? Not knowing if you would be sent home having been humiliated, with no treatment, and a large doctor’s bill your insurance plan refuses to cover? If as long as you didn’t get beaten up on the way home, would you say life is now good?

So, I wore purple on the 20th, and I extend appreciation to all the others around America who did so as well. But I have this to say: if you really want to help out, don’t just send smiling messages that life for LGBTI folks is fine after high school. Teach your children to respect all gender expressions and sexual orientations. Speak out against the way we are maltreated by institutions. Confront people on the street when you see them harassing us. Challenge school officials and parents and police officers who do nothing to stop the harassment. Be our good neighbors. Demonstrate your respect for all of us—not just to middle class married gay white suburban couples with 2.3 dogs. When you see someone who is visibly LGBTI on the street, smile at us. Advocate for same-sex marriage, yes, but remember the “T” and the “I” and also advocate for an end to sex assignment surgery on intersex infants, and for the respectful provision of medical care to trans folk. If you employer gives you health insurance, ask your HR department to negotiate for coverage of gender transition services. Take a step to ensure that life really does get better for your LGBTI fellow travelers. Please. . . wear purple, but do more than make a fashion statement.

Sunday, September 12, 2010

Interphobia--Not Cured by Hiding Us Away

This terribly disrespectful cartoon depresses me.

It's from a blog entry entitled "10 reason why Caster Semenya is a man. . . she set to run in June anyway," posted this April by a guy named Anthony. Here's a link, if you really want to see.

When Caster Semenya's name first became an international headline, I wrote a blog post about her situation, and I'm not going to revisit the specifics of her case now. Read the older post here if you wish. What I want to address now is the problem of bias against intersex people, which, following the conventions of the terms homophobia and transphobia, I'm terming interphobia. The cartoon of Caster Semenya standing to urinate from a presumed male phallus is an example of interphobic humor.

Caster Semenya's case has served as a lightening rod for interphobia.

If you wander the world of internet humor, you'll find plenty of other examples like the post by Anthony I discuss here. Internet mockery of Caster Semenya draws its vitriol from a variety of sources--you'll find it laced with sexist insecurities about women with athletic prowess, transphobia from authors who presume that Semenya is an MTF trans person, racism in the form of assertions that if she were a "real woman" she'd have straightened her hair--there's a whole banquet of bias being served up.
But there are specific elements of interphobia that lie front and center. There's a lot of prurient har-har speculation about her intersex genitalia, framing Semenya as someone whose genitals are on freakshow display. And there's castigation of Semenya for identifying with her sex of rearing.

What the cartoon I've shared from Anthony's blog post illustrates is rage at Semenya for identifying as female, iconically represented by which bathroom she uses. Thus Caster Semenya is shown both in a vulnerable position, at the toilet, and as smirking at the viewers as if daring them to do anything about the fact that she knows she is not a "real woman," illustrated by her standing to urinate. The text of Anthony's blog post is a list of body parts that he claims prove Semenya is "really a man," including even the shape of nostrils (!), but focusing most obsessively on the flatness of her breasts. "
NO breast...naada, not even 1% breast, not even fat man breast...," he declares, and, making fun of a photo of Semenya in a dress, he says "they dress up the person into a woman....but they failed to give it a cleavage or breast."


What Anthony concludes is that Caster Semenya is a man and should be running in men's races. He declares her a cheat by virtue of her intersex status, the sex she was assigned at birth wrong, and her gender identity as a woman unacceptable. Basically, Anthony wants to force Semenya to undergo gender transition against her will.

And Caster Semenya followed the rules.

There are rules we live under in our contemporary Western societies that I and many, many other intersex advocates have criticized. The rule that the spectrum of physical sex characteristics we are born with must be forced into dyadic sex assignments, often accompanied by unconsented-to infant genital surgery. The rule that we are supposed to grow up to identify with our sex of assignment. These rules, we are told, are for our own safety.

Doctors tell the families of genitally variant babies that without surgical sex assignment we will be treated as freaks, but surgery will protect us from pariah status. Some of us face traumatic "gender therapy" as children in an attempt to cause us to identify with the sex we were assigned, and again, our families are told this is for the best because it will protect us from ostracism. Our families are told to keep our status a secret. We're told to keep silent, fit in. Our intersex status will thus be erased, and we'll be safe.

Well, Caster Semenya was assigned female at birth, raised as a girl, and identifies as a woman. Her intersex status wasn't known to anyone at all--it wasn't even diagnosed until she was forced to undergo "gender verification testing" when some sore-losing competitors demanded it.

What this proves is that having one's intersex status secret is no protection at all.

We may pass as our assigned sexes--but at any time we may run into a circumstance under which our intersex status is revealed. We get in a car accident. We find ourselves with an ex with a grudge. We're thrust into the limelight, perhaps by winning a race. And we're outed--and thrust into the path of vicious interphobia. We face ER staff who take cell phone photos of our genitalia to send to their friends while we're unconscious, exes telling all of our Facebook circle that we're freaks, and random bloggers mocking us and declaring that we should be forced to gender transition.

The "solution" that doctors pose to the fact that intersex happens--to hide us all in the closet--does nothing to stop interphobia. In fact, it encourages it by making us vulnerable, isolating us from support, keeping us ashamed. The real solution is to fight interphobia directly. We need to come out, accept ourselves, and demand that others do the same.

Wednesday, September 1, 2010

Deaf Children, Intersex Children, and DSDs

I want to explain a division in our community, between intersex advocates and partisans of the terminology of "DSDs."

Every day, intersex children are born to parents who are shocked, lost at sea. "How can this be happening," they cry, "I've never even heard of such a thing." And this, this is the crux of the problem. It's this problem of being born as strange little changelings to our parents that perpetuates infant sex assignment surgery, despite the ever-mounting evidence that the results are frequently unsatisfactory. And it is the issue of how to approach infant sex assignment that lies behind our division into two warring camps: those who say the term "intersex" is overpolitical and imprecise and that the "proper" term is "Disorders of Sex Development," and those of us who say we are not disordered, and take pride in calling ourselves intersex people.

The intersex and DSD camps are constantly battling now, at least in the U.S. The thing is, this is not unique to our community. It is something we share with others. Similar controversies erupt around Deaf children born to hearing parents, for example, or, in some cases, children of color adopted by white parents. This commonality is very instructive--controversy arises when children of marginalized status are born or reared by parents who are privileged along that axis of identity.

Consider the organized Deaf community, which centers around institutions and locales where signing, ASL, is the norm. This Deaf community experiences itself as a linguistic minority, rather than "disabled." Members of such Deaf communities are not impaired in their daily lives. Able to communicate in their rich language with those around them, they are enabled to study and grow, and develop a strong culture, literature, and traditions.

The problem is that children who cannot hear are born to hearing parents all the time. And those parents are shocked, at sea. Some hearing parents don't want to give up on the future they had imagined for their children, and say, "I just want my child to be normal!" And "normal" for them means having their child live and go to school in a "mainstream" hearing context, and focus on learning to speak. It means getting cochlear implants and focusing everything on trying to make sense of a bit of sound. It means that these deaf children spend their days isolated, surrounded by people who can't understand them, and spending countless hours both in school and out trying to learn how to speak words they cannot hear, instead of quickly and easily learning a visual language they have the sensorium to perceive, and spending their hours at school learning math and history.

The signing Deaf community aches for these isolated children. They see the children as disabled by their parents, failed by the professionals who surround them, misunderstood by doctors. And the Deaf community pleads: please, parents, accept that your child cannot hear. Make them part of the Deaf community by allowing them to learn Sign from infancy; become part of the community yourself by learning Sign. Some parents take the message to heart and find their lives much enriched; others resist--but at least the message is out there, and Deaf children become aware of it soon enough. You can see a person born without hearing as defective, disabled, in need of medical alteration. Or you can see them as simply different, Deaf, members of a rich minority culture.

The split between the medicalized and cultural approaches to Deafness are parallel to the split between the advocates of DSD terminology and intersex activists, but the context is different, because there are no organized intersex institutions, no consolidated intersex neighborhoods. We have no Gallaudet (the excellent Deaf university in D.C.). The situation for intersex children is more like. . . well, imagine if all Deaf children were given forced cochlear implants and their families told to hide the equipment, never to let anyone know their children couldn't hear, and to avoid even acknowledging to the children themselves the issue of their not hearing. The parallel's not exact--it's harder to conceal sensory impairment--but it does give a sense of where we stand.

Most intersex/DSD advocates of any stripe share something in common: we want infant sex assignment surgery to be curtailed. We want intersex children to be allowed to retain their sexual sensation, any chance at fertility, and the right to have the gender identity that they develop be respected and recognized. Let the babies grow up, we plead, and decide what surgery, if any, they want. But the intersex advocacy community is small and diffuse, as compared to the Deaf community, and so far, we haven't gained much traction. Parents of intersex babies have never heard of us, and doctors dismiss us as a few disgruntled outliers. So every day in the U.S., babies continue to receive sex assignment surgery. Most of us continue to be raised in shame and utter secrecy, our genitals never looking "normal" after surgery anyway, but insensate, in pain, and often being reared as a sex we don't feel is ours.

The situation is bad, and something needs to be done about it. And this is where the small pool of intersex advocates splits. Who should we turn to for help? How can we improve the lives of intersex people? Will professionals save us? Or do we save ourselves, through community building and selfadvocacy?

Those of us who identify as intersex activists, in those terms, follow the route familiar to all civil rights' movements (and a fair number of us have been involved in LGBT politics). The basic model for improving marginalized lives, in the civil rights vein, is to take pride in one's identity, however stigmatized by the majority, and then to take action to get the majority to treat one's community better. The route to social change is rooted in embracing selfhood, and then moves on to a familiar array of tactics: be visible; protest; write letters to the editor, one's senator, one's pastor or rabbi; seek protective legislation, etc. etc..

So we act up. And one of the things we do is let people know we are very dissatisfied with how we have been treated by doctors. Unsurpisingly, many doctors have not appreciated this. It's damaging to one's selfimage, to listen seriously to a person who says, "You were not my savior or my hero--you hurt me, you did me wrong." Far easier for a doctor to dismiss our small if vocal group as a radical fringe, or perhaps to see us pityingly as the victims of older forms of surgery, very unlike the babies they now save from freakish lives with their newer, shinier surgeries.

And here's where advocates of DSD terminology chime in. They say, "We simply cannot afford to alienate the doctors, because it's the doctors' actions that make or break us. We need them to stop performing unnecessary surgery on babies' genitalia. And the only way to do that is to convince doctors that we are sane and not crazy. We need to be respectful to them, so that they will listen to us, and we can appeal to their desire to improve treatment." And so the advocates of "people with DSDs" are the political advocates of depoliticization. They argue, "Intersex activists are too far out there. Doctors see red when they hear the term 'intersex' now. Parents, too. Parents don't want to hear that their kid is some other sex, like permanently. In fact, lots of people in our own community are uncomfortable with the term. They don't want to be part of some group lumped together with queer activists, they just want to be seen as people."

I don't want to be seen as oversimplifying the DSD advocacy position--there are more nuances to it. You can read an eloquent defense of the terminology that is respectful to intersex-identified people here. But basically, the position is one of not rocking the boat. We should look to professionals, to doctors, to save us. If we're rational and polite and deferential and apolitical in our presenting of our case to doctors, then in time they will change the treatment regimens, and parents will listen to the medical professionals.

The thing is, similar lines of argument have been raised in the past. I recall in the 1980s, when many quiet, marginalized gay-identified people, living without protection from any nondiscrimination policies, looked to professionals to save them. Political activism, they argued, just alienated the populace. They looked to scientists to save them by finding the "gay gene." But it has been the brave actions of masses of LGBT people coming out at home and work and being politically active that have led to the gains in protection for LGBT people and same-sex couples, not some scientific discovery.

Or consider Dr. Martin Luther King, Jr.'s famous 1963 "Letter From a Birmingham Jail," an impassioned defense of nonviolently confrontational civil rights activism. The letter was addressed to a collection of moderate clergymen who had appealed to King to stop pushing sit-ins and to wait patiently for the legislature to produce civil rights protections. In due time, these clergy argued, if you are polite and trusting, these professionals will act. Just stop agitating, stop alienating them, be patient. But King was right--it was continuing civil rights activism that led to the enactment of the Civil Rights Act of 1964. I believe the lessons of our history are clear: if you want your people to be treated better, then take pride in who you are and demand your rights. And that is what I intend to do.

It's for this reason that I do not identify with the term "DSD." I am not disordered. I was born as nature intended me, and I feel no shame in that. I am an intersex person, and I personally have no interest in having my genitalia surgically altered. I shall not sit meekly by and wait for professionals to quietly change their minds about how to treat the young members of my community. I am going to be noisy and public in my demands, and I am going to work with our nascent social movement. My goal is to make the public aware that we are here, and that infant sex assignment surgery is making things worse rather than better for so many of us. It's public pressure and a shift in public opinion that will finally end the era of attempting to erase us medically. We will be recognized, respected, and no changes to our genitalia will be made unless and until we reach an age where we can request them, uncoerced.

In the future, I hope, when intersex babies are born, their parents, though probably still feeling shocked intially, will know that we are out here, leading happy lives. They can embrace their children--see them as members of a minority, yes, but also as lovely, not defective. They can learn from their children, about privilege and marginalization, to be sure, but also about the vibrance of human diversity. And these children will be able to connect with our community, help build our culture as a people, and contribute to the enrichment of our nation's web of identities, as today's Deaf community does.

Thursday, April 29, 2010

Five Myths that Hurt Intersex People

I've had conversations with some intersex acquaintances recently about painful situations in which (nonintersex) people have accused my friends of not "really" being intersex. Besides revealing how rude people in our society can be about policing sex and gender, what these conversations have illustrated are some central myths about intersex status that come up over and over again. It's these that I will address in this blog post.

Myth 1: Intersex people all have intermediate genitalia

Imagine this: you're an intersex person, nervous about dating and finding a partner. You work up your courage to disclose your status to people you're interested in, and after a series of them seeming polite but disinterested in dating, you finally meet a guy who expresses interest. You date for a while, and get to the point where the clothes come off. Your boyfriend gets a good look at you naked, accuses you of "making up that story of being intersex" because your body looks female to him, and breaks off the relationship, leaving you feeling misunderstood and ill-used.

Many people are intersexed in ways that are not visible to their partners. For example, an individual with AIS (androgen insensitivity syndrome) is born with internal testes but genitalia that look typically female. Intersex people born with visibly intermediate genitals are often subject to infant sex assignment surgery, another reason why our bodies may not appear visibly intersex to others.

What disturbs me about incidents in which a partner seems interested in dating an intersex person until the clothes come off is that it generally reveals that the partner was fetishizing the intersex person--only interested in them for their "exotic" body. In the situation described here, the boyfriend wanted to have sex with someone who looked genitally intermediate generally. I've also heard stories from intersex people whose genitals are visibly atypical about how a partner lost interest in them when the clothes came off because they didn't see the kind of "hermaphrodite" genitals they'd dreamt of, with a big penis and a vagina (a configuration almost unheard of in real life, but popular in pornographic fantasy). It's depressing to find out your date wasn't really interested in you, but in playing with some fantasy set of genitalia.

Myth 2: Intersex conditions are always diagnosed in infancy

Here's another unfortunate scenario: a person is having infertility problems, so they visit some doctors. They receive a diagnosis and turn in shock to an online gender forum to post "I was just diagnosed as intersex." Somebody responds, "Stop trolling this blog. You're not really intersex--intersex people all know what they are from childhood. You probably have sick fantasies or think saying you're intersex will give you an excuse to gender transition without controversy." The non-intersex person is accusing the intersex individual of being a non-intersex person exploiting intersex individuals, which is pretty ironic.

As noted above, many intersex conditions aren't obviously visible in external genitalia. That means that people may not find out about their intersex status until quite late in life. While the experiences of late-recognized intersex people are different from those of intersex folks diagnosed in infancy, they are not "less" intersex, and have to deal with physical and psychological ramifications for which they need support.

Myth 3: All infant sex-assignment surgery is aimed at creating "female" genitalia

Imagine this situation: you were born with intermediate genitalia but surgically assigned male at birth. However, you grew up hating your male sex assignment, and so you transitioned to female. Your experience has given you a lot of empathy for people viewed as gendertransgressive, so when you notice that a friend of a Facebook friend identifies as genderqueer, you write her a nice message and offer her friendship. She refuses your offer and writes you a nasty note back about how she knows you are lying about being intersex, since "all intersex children are made into girls." She accuses you of being a stalking, posing, creepy man-in-a-dress. Ironic and sad, isn't it--that a woman who identifies as breaking down the boundaries of sex and gender is policing those boundaries so rabidly and wrongheadedly?

It is true that intersex infants are disproportionately surgically assigned female, based on the appalling medical aphorism, "it's easier to make a hole than a pole." But some intersex infants are surgically assigned male--usually when they have at least one external testis, but sometimes under other conditions. The myth that this "never happens" leaves intersex people assigned male at birth open to constant suspicion and exclusion, increasing the difficulties they have to face.

Myth 4: Intersex people should be genderqueer

This myth comes up again and again in academic, activist and feminist circles: that intersex people, being neither male nor female in physical sex, must be genderqueer and androgynous. We're supposed to be standard-bearers for the fight to subvert artificial dyadic gender categories. Encountering an intersex person with an ordinary and "boring" masculine or feminine gender identity who doesn't look at all androgynous, these activists express puzzlement and disappointment--and in private, speculate that the person must have some minor, mild intersex condition, so they are not "intersex enough" to be insightful.

Intersex people face pressure from doctors and families and society at large to genderconform. Facing the opposite pressure to gendertransgress--subversivism-- is just as unfair. Yes, most intersex people open enough to disclose our sex status agree that it is damaging for our society to insist that everyone must identify as male or female. But we live in a society that understands gender dyadically, and like non-intersex people, we commonly identify as masculine or feminine.

Myth 5: "Real" intersex people are not genderqueer

Frustrated and upset by pressure from gender activists to gendertransgress, as descibed in Myth 4, some intersex people have created a reactionary opposite myth: that "real" intersex people have no interest in subverting dyadic gender understandings of male and female. These genderconservative individuals often don't actually identify as "intersex" but as "people with DSDs (Disorders of Sex Development)." And they go around arguing to institutions that "real" intersex people don't identify as genderqueer--that people who say they are intersex and argue for third gender categories and the like are posers, probably crazed feminist zealots or deceptive trans people.

What makes the myth that intersex people are never genderqueer particularly painful to me is that it is spread by members of our community. To undermine your own intersex siblings and deny their identities is counterproductive, pathetic, and cruel. Many intersex people identify as typically masculine or feminine people, but there are plenty who do not do so, and like all genderqueer people, they face a lot of social bias. We have no duty as intersex people to be genderqueer, but I see a strong moral imperative for us to support people who do have genderqueer identities and manners of selfexpression. There are enough hurtful myths circulating about intersex people already. We don't need to add one of our own to the mix.