Puberty Blocker Hypocrisy

 

Here's a handy graphic you can share that summarizes the hypocrisy of the laws that now ban gender-affirming care for those under 18 in half the states. 

All of them make an exception for intersex minors.The laws claim that puberty blockers are "experimental," "unproven," and putting patients' future bone health and fertility and body image at intolerable risk? That could be considered child abuse? Why, they are perfectly fine for intersex children. They're medically necessary! Proven, effective, and in use for decades.

Oh, and the genital reconstructions that absolutely nobody is performing on trans kids? Perfectly fine for intersex ones. 

There are only two possible conclusions. One is that legislators really believe puberty blockers constitute torture and child abuse--and think it is fine to torture and abuse intersex young people. More likely is the second: that the people enacting these laws don't really believe they are protecting trans kids from medical harm. They just want to make being trans illegal, while continuing to impose unrequested sex-change procedures on intersex kids whose bodies make them uncomfortable.

When Bigots Claim One Thing to Exclude Trans Athletes, and the Opposite to Exclude Intersex Athletes

This is Caster Semeya. Caster was assigned female at birth, without controversy, and raised as a girl. She always loved athletics. She found her calling as a runner, and trained hard, day after day, for years. In 2009, at age 18, she won gold in the World Championships 800 meter race. She was elated. But a competitor claimed to the officials that she did not believe Caster was really a woman. Caster was subjected to “sex verification” by an endocrinologist, a gynecologist, an internal medicine expert, an “expert on gender” and a psychologist. And it was found that she has an intersex status. In fact, the media found out before she did.

Caster has had to live her life under a gender-policing spotlight ever since. She’s been forced to take drugs to suppress her body’s naturally-high levels of testosterone, and had constant social media attention paid to how she dresses, the fact that she is a lesbian, and debates over whether the muscularity of her Black, athletic body reveals her admirable hard work and dedication to her sport, or some intolerable natural advantage.

Lately, transphobic “feminists”, otherwise known as the TERFs, have really been piling on Caster Semenya, in ways that reveal deep hypocrisy. Consider:

TERFs: There are only two sexes, you’re assigned one at birth, and that is your real eternal sex.

Also TERFs: I don’t care if Caster Semenya was assigned female at birth, he’s a man.

TERFs: Being raised as a girl socializes you to be a woman. Being raised as a boy socializes you to be a man. That determines your personality for all eternity and cannot be changed.

Also TERFs: You can tell just by looking at Caster that any attempt to raise him as a girl failed. Caster’s father says that as a child, Caster hated wearing dresses and liked to play sports with the boys.

TERFs: Trans boys are just girls who are tomboys with transgenderist parents! Their parents hate gender transgression and want to convert their inconvenient toyboy daughters into gender-conforming sons! Feminists must stand up for butch girls and save them!

Also TERFs: Caster Semenya walks like a man, dresses like a man, makes muscles like a man, and therefore is a man.

TERFs: When someone says a child or teen is a trans boy, the truth is that the youth is a lesbian, and their parents reject that and are forcing conversion therapy on their lesbian daughters to try to make them appear heterosexual by convincing the poor girls that they are really straight boys! We must stand up for lesbians!

Also TERFs: Caster Semenya married a woman, and the partner wore the white dress while Caster wore pants! Therefore Caster is a man.

TERFs: Prescribing medication to suppress someone’s sex hormones is pointless, as it doesn’t change who you really are. Also, it’s experimental, goes against nature, and is an intolerable thing to suggest to anyone.

Also TERFs: It is absolutely vital that Semenya be made to take testosterone suppressants, and be tested before every race.

TERFs: Taking testosterone or estrogen can’t change your sex. You are the sex you were assigned at birth.

Also TERFs: It’s irrelevant that Caster Semenya was assigned female at birth. Caster’s body was flooded with testosterone at puberty, making him male.

TERFs: Transgenderism is based on enforcing gender stereotypes. It equates being a woman with looking pretty and delicate and wearing makeup and being submissive. That’s evil misogyny!

Also TERFs: I can tell who is really a woman by looking at them, and that’s not a real woman. Caster’s too muscular, never wears makeup, is aggressive, and looks like a man. It’s not misogyny if *I* do the gender-policing.

There’s so much hypocrisy in all of this. And lest we forget, in Caster Semeya’s case, a whole lot of racism as well. The competitors who have challenged Caster’s right to compete have all been white women, crying white-women tears for the cameras. The TERFs who’ve been serving as talking heads in media interviews? Also a bunch of white women. There’s one who seems to find every Twitter conversation on the topic and post photos contrasting women athletes she claims are “really men” due to presumed intersex status—every one of them Black or brown—with women she says have been cheated of their rightful medals—all white.

(This makes me recall the weird racist claims made by a certain fringe about Michelle Obama—that she was really a trans woman or intersex, because she was too strong, and seemed to the racist detractors to have overly-broad shoulders.)

In the end, what we see are that trans-exclusive “feminists” are largely white women who believe they have ownership of the category of woman by right. And they seem to have no problem with deploying one set of arguments to exclude trans women, and totally opposite arguments to exclude intersex women. It’s sad and it’s ugly.

Yet Caster Semenya continues to rise up to compete, enduring intrusive media questions about her genitals, endless discussions of her dress and demeanor, and years of being forced to take testosterone-suppressant drugs against her will in a way that no person competing in men’s sports, no matter how high his natural testosterone levels, has ever been forced to do. Sometimes she’s allowed to compete and sometimes barred from competition, depending on rules that keep being changed for how typical a woman’s body must be in order for her to qualify for the Olympics.

Remember this: virtually every person competing in the Olympics has an atypical body. These athletes may be endowed with atypical levels of fast-twitch muscle, or unusually flexible joints, or huge lungs, or extraordinarily long legs. We don’t police these biological differences, or require that to compete in the Olympics, you must have an average body. We don't randomly pick citizens of each nation to compete in international sporting events--we get to see average people running for the bus all the time. We don't find this exciting, and it's the very atypicality of elite athletes' bodies that enthralls us. It's only this very specific type of atypicality--being a woman with hormonal or genital or chromosomal variance--that has been policed. And it's policed intensively, intrusively, punitively.

And it’s all based on magical thinking about what testosterone does. Ten percent of cisgender women have PCOS, which makes them produce high levels of testosterone, but doesn’t magically make them athletic. And actually, when studied, it turns out that 17% of elite male athletes have testosterone levels below the bottom of the "male range." These men are not disqualified as "cheating by being intersex." They aren't regulated at all, probably because it's presumed that their low testosterone must be a disadvantage. Yet these men with low testosterone are not lesser athletes; they are just as extraordinary in their performance as the men with typical testosterone levels. This illustrates how there's no direct relationship between the amount of testosterone a person produces and their athletic abilities.

I myself am an intersex man, who has been taking testosterone for many years. My athletic abilities? Well, they’re better than those of a potato. But they are poor. What sort of feminist would argue that I should not be allowed to compete against women Olympians, because I have an innate male advantage over them and would win? That’s magical thinking, of a sort that posits a binary of male superiority and female inferiority. And it’s ridiculous.

The last thing a feminist should be doing is gender-policing women, telling them if they get too strong and muscular, they are no longer women. That refusing to wear dresses makes them men. That marrying a woman discredits them.

That’s not feminism, friends.

Understanding the Biblical Binary of "Male and Female"

 

According to certain Christians, the fact that the Bible states "male and female created He them" means that God only recognizes two genders, those assigned at birth. To be trans or nonbinary is unacceptable, and intersex status a tragic birth defect that must be corrected.

Of course, the Bible also says "the Lord makes poor and rich." This binary of rich and poor appears multiple times in biblical language. Do conservative Christians therefore say it is an abomination to be middle class?

Or consider the verse, "He will bless his loyal followers, both young and old." You'll find this binary of young and old many times. Yet there is no Christian movement to declare that people cannot be known as middle-aged, but must either be designated as old or as young.

The phrase "male and female created He them" comes from the book of Genesis, in what Christians call the Old Testament and Jews call the Torah. Christianity started as a Jewish sect, reading Jewish Torah scrolls, and practicing Jewish religious traditions. Many of these traditions were relinquished fairly early in Christianity, such as the requirement of circumcision. By 300 years in, kosher dietary laws had been abandoned.

But many other Jewish traditions lasted much longer. One of these was recognition of intersex babies. Under the Jewish religious rules of halacha, babies were not just classified as male or female, but under a four-sex system that also designated babies androgyne (both) or tumtum (neither). People born androgyne were to perform the religious duties assigned to both men and women; people born tumtum were not required to practice either set of duties. Jewish tradition also recognized additional categories for those whose gender status changed, due to intersex characteristics manifesting at puberty, or to never experiencing puberty at all, or to human intervention such as surgery--all categories later Christians would lump together as "eunuchs."

For many centuries, Christians recognized androgynes, tumtums, and eunuchs as well as men and women. The Church canonized saints with these designations. It was not until the Middle Ages that the novel idea arose that the phrase "male and female created He them" was not a poetic dyad, but a limitation the Church should implement in categorizing human beings. And the courts immediately started dealing with a stream of cases involving people assigned to one binary sex at birth, but living as the other, or living in their birth-assigned sexes but having intersex bodies that they or the community felt was more like the sex to which they were not originally assigned.

This shift from accepting sex and gender diversity to squashing it into a binary was awkward from the very first. And violent, too: some intersex people were burned at the stake, like witches. The categories of witch, intersex person, and gender-transgressor were often conflated. It was a ugly time in history--witness the Inquisition--in which all sorts of people who deviated from norms were tortured and burned alive in the name of God.

Today, Christians are not in the witch-burning business. That period of history is viewed as one of superstition and terrible persecution. Yet some conservative Christians continue to revile people who are gender expansive, deem gender transition illegitimate, and demand that intersex babies receive forced genital reconstruction. They claim they must impose an eternal binary, for the Bible tells them so.

But there's no need for that. The phrase "male and female created He them" is a poetic dyad, just like the phrases "rich and poor" or "old and young."

Persecuting the socially marginal is the exact opposite of what Jesus called on Christians to do. Justifying such persecution by referencing a snippet of poetic Biblical language is not just nonsense. It is a great moral wrong

The Department of Inhumanity and Ideological Services

A memo was recently leaked from the Department of Health and Human Services. In it, the HHS defines sex as a binary determined by chromosomes (presumed to come in only two forms, XX or XY), and states that sex cannot be changed.

The memo has caused outrage, because its goal is to define gender transition out of existence. Its aim is to discriminate against trans people, declaring them to be deluded or deceptive, their lived genders irrelevant. In so doing, it ignores the conclusions of every mainstream medical and psychological association, which is a bizarre position for a department supposedly aimed at recognizing and supporting medical treatment paradigms to take. Unrecognized as yet is how this proposed policy would also work to shatter the lives of intersex people. As is so often the case, intersex people's lives and needs go unrecognized, so in this post I will try counter that.

First, we need to understand where this memo is coming from. The Director of the HHS Office of Civil Rights is currently Roger Severino. He used to work for the Heritage Foundation. He has no special knowledge of medical issues--he was hired by the Trump administration to please conservative Christian groups. He is an advocate of conversion therapy for LGBT people. He says being LGBT is "against biology." He believes in a radical conservative Christian ideology that states that patriarchy, heterosexuality, and cisgenderism are compelled by the Bible and nature, and that Christians are forbidden from tolerating gender egalitarianism or LGBT people. Unsurprisingly if very sadly, rather than doing his job as Director of the HHS Office of Civil Rights, which is to see that the medical needs of all people, as understood by the medical profession, are met, he is seeking to impose his ideology. Rather than fostering humanity and human services, he seeks to advance discrimination and a radically conservative ideology of sex and gender.

What's especially insidious is that this extremist political position is not being proposed for debate--not that human rights recognized by the UN and international community should be debatable. But by inserting its bigoted assertion--that sex is a binary determined by chromosomes that cannot be challenged or changed--into the HHS definition, radical conservative Christian ideology is disguised as scientific fact. This is a common tactic today in that segment of the far American right that seeks to dismiss scientific consensus. They find some person of supposed authority who will ignore what the vast majority of experts affirm to be true, and present the assertions of that person as "disproving" the voice of the vast majority--this is very evident when we look at their approach to defying the national and international consensus of climate scientists.

In this case, the action is even more radical. The idea is to have the institution created to protect people's rights to health simply declare gender transition invalid. Many Americans will be unaware of the politicization of what is supposed to be a scientific body. They will believe that the medical profession actually opposes recognition of trans people's identities based on scientific study. Therefore, they will believe they need feel no guilt when gender policing people, and discriminating against those whose appearance strikes them as insufficiently conforming to binary sex and gender expectations.

As an intersex person who has gender transitioned, I can attest that if this proposed policy becomes law, trans people--some of whom are intersex--will suffer greatly. This is the aim of the radical conservative Christians who have been given an outsized voice by the Trump Administration. I have lived a decade in my identified gender as a man. My wife, an intersex woman, started her gender transition over two decades ago, as soon as she turned 18 and could control her own medical destiny. These decades of our lives, our gender identities, and the understandings of our friends, families and colleagues would all be declared lies. Humiliating us by misgendering us would be proclaimed "healthy." Discrimination against us would be declared justified.

But many more people than just trans people would suffer. The majority of intersex people in the U.S. today do not gender transition. But all of us have been fighting for social acceptance, for an end to infant genital surgeries that rob us of the capacity for sexual sensation, and against the stigmatizing and concealment of physical sex variance. Our battle as intersex people has been for recognition of the sex spectrum, and for respecting our physical sex diversity.

Think what will happen to us now. Consider, for example, those of us who have complete androgen insensitivity syndrome, born with female-typical genitalia but XY chromosomes. Virtually all people with XY, CAIS are assigned female at birth and are raised as girls--but suddenly, they'd be declared men. This would disrupt not only their lives, but those of their parents, their spouses, their neighbors and friends. Or consider all the children born with intermediate genitalia. Doctors have forced surgeries onto so many, basing their decision on factors like gonads, or surgical convenience. Suddenly, many intersex people would find that the surgeries forced on them took away the parts of their bodies that the new HHS policy declares to be the ones that should have been kept under the new chromosomal standard. This will compound their trauma--and perhaps lead to a further round of unwanted surgical interventions.

For those of us intersex people whose chromosomes are XX or XY, this new policy would counter all of our efforts to push back against forcing sex reassignment surgeries onto us, mutilating our genitals. Instead, the policy would declare that these are not sex reassignment surgeries at all, because our penises are "false penises," our vaginae "fake." And for those of us who have one of the many other sex genotypes this policy fails to recognize--XXY, XYY, Xo, XX/XY, etc.--ironically, even if our bodies have appeared typical enough that we've escaped surgical mutilation or social stigma, suddenly, we become the "true intersex," our lived genders falsified, leading to confusion, discrimination and shame.

The intersex community's central goal for many years has been to put an end to nonconsensual infant genital reconstructions. And our best bet for seeing this happen has been to educate parents--to let them know that intersex status is fairly common and in no way a tragedy, so long as children have the respect and support of their communities. This HHS policy would undo our good work in parental education by declaring to parents that what we've been telling them is false. The HHS policy says that only binary sex can be recognized, physical sex variance is intolerable, and "corrective" surgery a necessity. This is a tragedy for our community.

The deepest irony here is that we as intersex people have bodies that prove that this proposed HHS policy is, to be blunt, complete BS. Sex is not a binary--empirically speaking, it is a spectrum. If you look at world societies over history, most have recognized more than two sexes. This is not because until the modern West appeared with its binary gender ideology, everyone was deluded--it's because there have always been intersex people. The capacity to attempt to erase us surgically is only a century old, and other societies dealt with us very differently--by recognizing and accommodating us. Sadly, binary gender ideology is so passionately adhered to in our society that most Americans are unaware of both this world history of diversity in social sex categories, and of the prevalence of intersex people today.

And what this proposed inhuman policy does is attempt to codify that ignorance, declaring binary sex ideology the law of the land. The aim is to trample upon trans people--but the victims will include intersex folks, and empirical truth.

Nonconsensual Intersex Surgery as Physical Conversion Therapy

Today, most people think of conversion therapy as a discredited practice of the past. Back in the bad old days, being "homosexual" was considered a mental disorder that psychologists tried to cure. But being gay was depathologized by the American Psychological Association back in 1972, and today, same-gender couples are socially accepted and have the constitutional right to marry. A small number of evangelical Christian "therapists" still attempt conversion therapy on LGBT people, but they are considered quacks by the medical profession and most of American society. The days of conversion therapy are seen as basically over.

They are not.

I am going to argue to you that "corrective," "normalizing" surgeries performed on intersex children who cannot give or withhold consent are conversion therapies. They are motivated by the same constellation of  ideas that produced conversion therapies aimed at LGBT people. And they take place way more often than most people think. Conversion therapies are alive and well and being imposed every day on unconsenting children in the U.S., harming them.

Mainstream medical practitioners in America today distinguish between LGBT conversion therapies and intersex "corrective" procedures. They frame conversion therapies for sexual or gender identity as wrong because they now agree there is nothing pathological about being queer, trans, or gender-nonconforming. These are minority identities, and trying to "cure" them is akin to doctors attempting to cure people of identifying as Jews or Muslims. It is not the place of the medical profession to impose the majority religious or sexual ideology on patients, and doctors who try to do so are violating professional ethics.

Intersex status, on the other hand, is pathological according to contemporary Western medicine. Physical sex variations are medically classified as "disorders of sexual development." It is the job of doctors to cure disorders. They sat that intersex people are born with tragic malformations, and we will live as social outcasts unless the medical profession heroically steps in to save us by converting our abnormal intersex bodies into endosex-appearing, normal bodies.

A Brief History of Conversion Therapies

The mid-20th century was the heyday of conversion therapies. This was an era of conformity, of faith in medical authority, and of optimism that social ills could be cured by science. It was taken as an article of faith that doctors should seek to convert deviance to normalcy. Funds were directed to developing a wide array of innovative medical interventions toward that end.

A key arena for the development of therapies was producing "normal sex." This midcentury umbrella term encompassed a wide array of matters related to sex, gender and sexuality. The goal was to ensure "natural sex relations." According to the scientific ideology of the time, evolutionary biology required that humans come in two opposite sexes--dominant, competitive men and gentle, nurturant women--who would be drawn by heterosexual attraction to form stable marital units, the necessary basis for parenting. The survival of humanity was believed to require bodies of binary sex, people who conform to binary gender stereotypes, and compulsory heterosexuality.

In the 1950s and 1960s, the medical profession made great investments in developing and institutionalizing conversion therapies, both psychological and physical. These therapies became mainstream and widespread. Doctors aimed to cure "hermaphroditism and pseudohermaphrodism" (i.e. intersex status), "sexual deviance and transvestism" (i.e. LGBT status), and gender nonconformity (under many labels, including "sissy boy syndrome" and  "neurotic penis envy").

The therapies doctors developed were deeply interventionist--often traumatizing and painful. To be converted from deviant to normal was seen as a positive outcome that justified a steep personal price. People with nonconforming sexual orientations, gender identities, and gender expressions were often institutionalized. Some were given electroconvulsive shock treatments. Many were treated with aversion therapies--for example, being given painful shocks, perhaps to their genitals, while being shown same-gender erotica. These "treatments" amounted to torture, and while they could not change people's identities, they could render people incapable of arousal or of sexual relationships. Today, we see such an outcome as tragedy, but at the time, being incapacitated by panic and nausea when triggered by sexual arousal was viewed as better than being able to engage in same-gender sexual relations.

In this same time frame, "corrective" surgeries on intersex children became the norm. The goal of these surgical, hormonal, and other interventions was to produce a person who appeared endosex and was capable of engaging in penetrative penile/vaginal intercourse. Sexual sensation, freedom from pain, and issues of gender identity were dismissed as irrelevant. The goal was to enforce "normal sex" by creating a person who appeared to be of binary sex, was gender-conforming, and who had heterosexual intercourse, whatever the costs. This was very much in line with the painful treatments being imposed on LGBT people at the time.

Prettying Up Conversion Therapies

After the Stonewall uprising in 1969 and the rise of second-wave feminism, conversion therapies came under attack for enforcing compulsory heterosexuality and gender conformity. Lesbian and gay advocates successfully got homosexuality removed from the DSM, the "bible" of psychological diagnoses, in 1972. And supposedly, since then, nonconsensual conversion therapies became a thing of the past.

But in reality, conversion therapies persisted--they just put on an acceptable mask. Homosexuality was no longer classified as a mental illness, but being unhappy about being gay was (this was "ego dystonic homosexuality"). So therapists could still practice conversion therapies on LGB people, so long as they got the patients' consent--or, if they were minors, their parents gave consent and told the therapists their children's "homosexual tendencies" were causing depression.

Meanwhile, mainstream sexual orientation and feminist advocacy organizations of the 1960s-1980s largely ignored or actively opposed trans people's rights. So being trans remained classified as a mental illness, "gender identity disorder." A small number of fortunate trans women and a tiny number of trans men were able to use this diagnosis to access gender transition services during these decades. These individuals had financial resources, bodies that doctors deemed would not be visibly trans after hormonal and surgical treatment, and a demeanor and gestural repertoire that would be gender-conforming after transition, in accordance with the ideology of natural sex/gender binarism doctors were still enforcing. But most trans people were refused access to transition services by medical gatekeepers. Having failed one or more of the enforced gatekeeping criteria, they were instead treated with conversion talk therapies intended to resign them to living in their birth-assigned genders.

As for physical intersex conversion therapies, to the extent they appeared at all on the radar of progressive political activists in the post-Stonewall decades, it was in a positive light. Dr. John Money became something of a celebrity in this period. Money performed intersex "normalizing" surgeries, but became most famous for "treating" one of a pair of identical twin baby boys. This child was the victim of a botched circumcision, in which he lost the head of his penis. Money gave that infant sex reassignment surgery and had the parents raise the child as a girl. In his reports on the case, Money claimed that by enforcing strong gender stereotypes in their parenting, the end result was that the identical twins became a happy girl and a happy boy, both of them gender-conforming. In fact, that was not the case--the surgically reassigned child was never happy, gender transitioned back living as a boy in his teens, and committed suicide in his 20s. But in the 1970s, feminists and progressives saw the case as a cause célèbre, because it was framed as illustrating that gender is socially constructed and not some natural or innate matter.

Money became so famous as a result of this that his paradigm for the treatment of intersex infants became universal in the West. Money held that visibly intersex children should receive genital reconstruction as early in life as possible, so that their parents would raise them as "normal girls and boys," producing well-adjusted heterosexual women and men. So unlike sexual orientation conversion therapies, which had to become much more polite and consensual, intersex conversion therapies actually became more invasive, ubiquitous, and less consensual. 

The Spread of Resistance to Conversion Therapies

In the final years of the 20th century, advocacy movements for sex, gender and sexual minorities pushed back at the persistence of conversion therapies. Sexual orientation advocacy organizations did this overtly. They fought active campaigns against the idea of conversion therapy for LGB people, and in 1987 "ego dystonic homosexuality" was removed from the DSM. Conversion therapy aimed at LGB people was officially disclaimed by the American Psychological Association.

Trans advocates also overtly pushed back at conversion therapies. They focused particularly on the diagnosis of Gender Identity Disorder of Childhood. There being no protocols for social transition for children at the time, children given the "GID of Childhood" diagnosis were all treated with conversion therapies. Some of these children we'd recognize today as trans kids, but often the youths being "treated" had never expressed a trans identity--they were your classic feminine boys and tomboys, or LGB teens whose parents opposed their sexual orientations. Many were institutionalized against their will by their parents. And punitive aversion therapies, often involving physical punishments, were commonplace. The goals of these treatments were to produce complete conformity to the child's assigned binary gender. Trans advocates pushed back against this, and were joined in this instance by LGB and feminist activists.

Trans groups were also engaging in other advocacy efforts that amounted to fighting conversion therapies, but were not framed as such. Trans people were struggling against the gatekeeping by doctors that kept so many trans-identified people from accessing transition therapies. They were pushing for a different pathway to accessing transition services--one now called the "risk reduction approach," in which a patient signs a declaration attesting to their gender identiy and is then allowed to access services after some simple screenings. This advocacy was pushing back at the channeling of a majority of patients wishing to gender transition into cisgender conversion therapies instead of their desired transition treatments. Success in this advocacy let to the bypassing of extensive medical gatekeeping, which in turn led to rapid growth in the number of people accessing transition services. Especially empowered were those who were excluded in the past because they had nonbinary gender identities, would be LGB or gender-nonconforming after transition, and/or would remain visibly transgender after accessing hormones and the surgeries they desired and could afford. For many, conversion talk therapies were replaced with access to transition services.

This pushback against conversion therapies in the 1990s led to the burst of trans visibility in the 21st century. But intersex people still remain largely invisible.

That's because our fight against conversion therapies lags decades behind LGBT battles on these issues. The first major intersex advocacy group wasn't even founded until the 1990s. Having heard no intersex voices of protest, most endosex progressives entered the 21st century thinking of intersexuality as vanishingly rare, and of infant genital reconstruction as some cool proof of the flexibility of gender.

21st Century Intersex Advocacy

Most people today remain unaware of how common intersex status is. I explain its prevalence here: about 1 in 150 Americans is diagnosed with a "disorder of sex development." The fact that people aren't aware of how commonplace intersex status is illustrates the effectiveness of repressive conversion therapies. The very point of intersex surgeries performed in infancy without our consent is to render us invisible. For decades, the treatment paradigm included keeping our medical histories secret from us--lying to us about the nature of our treatments to hide our intersex status even from ourselves. For decades, our parents were told that if anyone learned of our secret, our lives would be ruined, so we must be taught never to talk about our differences. There's been more openness in the last decade--but doctors' diagnostic categories themselves continue to seek to convert us to endosex by concealing the nature of our differences. Rather than being told we are intersex, these diagnostic terms often label us "boys with a penile deformity" or "girls with clitoromegaly." We're told these are embarrassing issues, but ones doctors can cure for us with a few simple surgeries, so nobody will ever know and we'll never have to have the embarrassing problem revealed.

We live in a culture of shame and stigma in which intersex people are still taught that if our variance becomes known, potential friends and mates will be repelled and we will be doomed to lives of isolation. Doctors present us with a solution: physical conversion therapy to erase our physical sex variance, and silence about this ever having occurred. And it works, at least on one level. Few contemporary Americans are aware of how many intersex people are all around them.

But conversion therapies continue to come at a severe cost. For us, these include physical costs: the loss of sexual sensation that accompanies so many infant genital reconstructions; pain; infections. We are forced to show our genitals over and over to strange adults who poke and prod us, and then we are expected not to talk about it, which is a great training regimen to make us vulnerable to sexual abuse. And there's the fundamental issue of agency and self-determination over our physical sex characteristics. For those of us who don't grow up to identify with the binary sex we were coercively assigned at birth, there's the betrayal of knowing our bodies once better matched our identities, but then doctors cut off parts of us with which we identify, and our parents just went along with it. And even if we are in the majority that do grow up to accept our assigned binary sex, all intersex children whose genitals and gonads are surgically altered have endured a forced sex change--something our society would find horrific in endosex children, but accept in our case--and that is very hard to deal with.

And the thing is, conversion therapies never solve the fundamental problem. The problem is that the patient is a member of a stigmatized group. Even if a perfect conversion of a patient to endosex, to cisgender identity, to heterosexuality, or to gender conformity were possible, it only allows that specific patient to escape a social problem that persists. The real solution is to end stigma and discrimination against the minority group, so that every member of the group benefits.

Rather than reducing stigma and discrimination, conversion therapies strengthen them. They naturalize the discrimination and blame the victim.

The young intersex advocacy movement has tried several approaches to addressing the social problems we face. We've formed support groups. We've tried to work with doctors, hoping that if we are polite and educated and assimilated and attractive, they will listen to us and at least delay surgeries to allow children to mature enough express an opinion about whether they want them. The medical profession has been happy to co-opt us and present their uninterrupted intervention practices as having our seal of approval. We've tried confronting doctors individually. They call us atypical malcontents who received outdated surgeries, while they present current surgeries as cutting edge and advanced, with zero data to show any improvement in outcomes. We've tried analogizing infant genital "normalizing" surgeries to the cultural practices Western doctors call "female genital mutilation" and deem barbaric. Both are medically unnecessary cosmetic practices meant to make our bodies appear culturally acceptable to potential mates that traumatize us and deprive us of sensation. This convinced the U.N. to call for an end to unconsented-to medically unnecessary infant genital reconstructions, but basically only tiny Malta banned the practice. In the U.S. and most wealthy industrialized nations, medical interventions continue unabated. Doctors just frame every surgery they do as medically necessary to correct "disorder."

Doctors will only stop performing infant genital reconstructions to enforce their ideology that bodies must conform to binary sex expectations when parents stop consenting to it. In the 21st century we've been trying to educate the population about intersex issues, so parents will cease consenting. But it's been hard to get traction. One problem is that the medicalization of sex variance turns every conversation about intersex issues into a complex story of 17 diagnostic categories, and what each means, and how to evaluate twisted medical claims that surgeries they perform are necessary to enhance fertility (which they mostly reduce) or prevent cancer (which occurs at rates way, way lower than breast cancer--and we don't preemptively remove all breasts like doctors want to remove all internal testes and ovotestes). Medical terminology confuses most average people, and we are trained to defer to medical authority, so listeners often give up trying to process what we are saying.

That's why I suggest we make clear what intersex surgery is. It is a conversion therapy. Doctors say it's necessary to cure disorder and prevent stigma. But they said exactly the same thing about LGBT conversion therapies, until social movements made them relinquish these (lucrative) practices. LGBT conversion therapies were practiced in service to the ideology of "natural sex;" the same is true of intersex physical conversion therapies. But homosexuality is not "unnatural;" same-sex sexuality is found throughout nature. Trans identities are not "unnatural;" gender-crossing is found throughout history. And intersexuality is not "unnatural;" empirically speaking, sex is naturally a spectrum and not a binary.

The public doesn't have to enter a debate about multiple complex medical treatment paradigms any more than the public needed to read psychological journal articles comparing the efficacy of different aversion therapies.

The simple fact is that no person should ever be forced to endure a conversion therapy. No intersex child should be forced to have medical interventions to convert their bodies to appearing endosex. Genital reconstructions should only be performed on mature people who ask for them--whether intersex or endosex, cis or trans.

Having an intermediate phalloclitoris is no more inherently medically dangerous than having a penis or vulva. The danger that comes with having intermediate sex characteristics is purely social and comes from living in a society that discriminates against people whose bodies don't conform to binary sex expectations. The way to protect people from that is to ban the discrimination, not to try to conceal an individual's nonconformity so that that one individual escapes the discrimination.

Stop nonconsensual intersex surgeries. They are conversion therapies, and they are wrong.


 

 

The Problematic Ideology of Natural Sex

What is human nature?

In the Western world today, science and religion are often understood to be enemies. It’s believed they offer two competing explanations of how the world works. What I want to show you is how when it comes to understanding human nature, Christianity and Science are in fact complete bedfellows. They both are deeply invested in a belief system, which I will call the Ideology of Natural Sex. And both have been shoring up that ideology, enforcing it brutally, and imposing it by force on others around the globe, for centuries.

What is this Ideology of Natural Sex? What do authorities from the Pope to our medical and scientific textbooks jointly believe, and insist we believe, about sex? It’s their unified theory of sex, gender and sexuality, and it goes like this:

“As ordered by God/evolutionary biology, humans come in two and only two physical sexes. This is the nature of things because a male and a female make a reproductive unit. The purpose of sexual interaction is reproduction. Thus, the determinative factor in dividing men from women is genitalia. Genitalia determine gender—the way society organizes people through gender roles, and the way people should properly identify and understand their place in the world. And this world is one in which men are (by God’s design or by biological imperative) the dominant sex, the sexual “aggressor,” while women’s interests center on nurturing families and offspring.”

Four things that are central to my own life pose challenges to this ideology. The first is that the empirical reality of physical sex is that it is a spectrum, and people, like myself, have always been born intersex. The second is that people around the world and throughout history have identified with genders other than male or female, and/or have been assigned to one sex at birth, and felt called to move to live in another. The third is that people engage in sex all the time that is not procreative. This is true of people who are infertile, people in same-sex pairings, and fertile men and women who do not wish to conceive with one another at the time of their sexual interaction. And the last is the reality that gender inequality is not inevitable. Patriarchy, the privileging of men over women, is a form of inequity that is successfully being reduced.

How have religious and scientific authorities dealt with these challenges over the past several centuries? They have periodically declared them to be “unnatural.”

Now, if ever you want to know when to suspect an ideology is at work, you can be sure it is the case when someone tells you something is unnatural and should not occur. Because here’s the thing about true natural laws: they function whether you want them to or not. Nobody needs to urge or force anyone else to obey them. Consider gravity. It’s a natural law, so nobody needs to enforce it. No religious tracts or psychological textbooks have been written urging people to obey the principle of gravity and refrain from floating about bumping into ceilings. Or consider this example: people may argue over vegetarianism, and whether it is healthy. But you have never seen a letter to the editor or an internet comment war complaining about how kids these days are engaging in the unnatural practice of giving up both meat and vegetables and choosing to engage in photosynthesis instead.

There is no #PhotosynthesisIsUnnatural hashtag because it truly is unnatural for people to turn green and live off sunlight directly instead of eating things for energy. Truly unnatural things do not occur, so they generate no outrage squads decrying their transgression.

As for the “laws of natural sex”—well, it’s another story.

Around the world, over the past four or five hundred years, people have been cajoled, threatened, forcibly re-educated, beaten, imprisoned, locked in mental hospitals, put in the stocks, publicly humiliated, mutilated, and burnt at the stake for violating one or more of the precepts of “Natural Sex.” That’s the sure sign of enforced ideology, not a true natural law.

And it’s not just a story of superstitious, ignorant days gone by. There is a war being waged over the ideology of “Natural Sex” today. And in that war, religion and science stand hand in hand on the same side. Who stands on the other?

Intersex people whose genitals are surgically mutilated without their consent to force their bodies to resemble binary sex expectations.

Trans people who are treated as having a mental illness, as delusional, as perverted, as pariahs.

People in same-gender relationships, who have made great strides in the West recently in terms of a right to secular marriages, but who are still not permitted to marry in many religious denominations, and who are not protected from perfectly legal discrimination of many sorts in many places.

Oh, and women pursuing sexual pleasure. Religious authorities frame women in particular as ruining themselves through seeking sex outside the context of marriage. Meanwhile, scientists continue to frame female orgasm as a puzzle as they state it is “unnecessary,” since women can conceive without it. Women, according to both religion and science, should want babies, and only engage in sex to make them, not for fun.

The extraordinary thing is, with so many groups fighting and suffering for recognition denied them under the ideology of “natural sex,” how incredibly powerful that ideology is, how amazingly resilient. We are taught the Ideology of Natural Sex so early, by parents and media and schools and churches, that we believe in it at the same fundamental level that we believe in things like gravity.

And even when individuals are persecuted in some way under the Ideology of Natural Sex, very often it never occurs to them to challenge the whole, as that seems unthinkable, but only one small part of the ideology impacting them particularly. Thus we have women who decry female genital mutilation as cruelly enforcing the belief that women should not have sex for pleasure, yet who see similar surgeries being performed on intersex babies as appropriate, as heroically “correcting malformation.” We have gay men and lesbians who frame themselves as natural and normal, wanting only to marry and reproduce like anyone else, while disdaining trans people as "crazies" who are making gay people look bad by association under the LGBT umbrella. We have people born with sex-variant bodies who reject the label intersex, and wish only to be referred to as “people affected by disorders of sex development.” Why? Because they are worried that the term “intersex” will make others associate them with trans people or think they have nonbinary identities or otherwise find them disturbingly transgressive of the Ideology of Natural Sex, and God forbid, they don’t want any of those things to be thought of them.

And everywhere, everywhere, we have ignorance of the long and violent history of the imposition of the Ideology of Natural Sex under European colonialism.

The genius behind framing an ideology as “natural” is that its history erases itself. Why would anyone study the history of something natural and eternal? We don’t study the history of covalent bonds in chemistry or cumulus clouds in meteorology.  And so we don’t study the spread of European binary sex ideology under colonialism. If you do, you’ll find that all over the world before European colonialism there were societies recognizing three, four, or more sexes and allowing people to move between them—but that’s a subject for another post. Suffice it to say that societies were violently restructured under European colonialism in many ways, and one of those was the stamping out of nonbinary gender categories and stigmatization of those occupying them as perverts.

Meanwhile, missionaries and European scientists spread the word that nonprocreative sexual practices—same-gender relationships, oral sex, masturbation—violated God’s will or the scientifically known purpose of sex, and were thus both sinful and sick. Christian missionaries even taught that the only acceptable intercourse involved a married man atop his wife, other positions being “unnatural.” Scientists concurred, saying that only in the missionary position would gravity lead semen to the uterus. Nature, colonized peoples were taught, requires men to be on top--of society, and in sexual activity, literally.

Most people today are ignorant of this history of the ongoing struggles to impose the Ideology of Natural Sex on reluctant nations and social groups. This ignorance allows each generation to believe that those who do not fit under the ideology, such as intersex and trans people, are rare freaks—or, if there are many challenging the ideology at that time, such as feminists demanding access to birth control and abortion, or the gay pride movement, as a brand new threat to an until-then-eternal system.

And for a system that is presented as eternal and inevitable, the Ideology of Natural Sex is also strangely framed as fragile and endangered, requiring vigorous defense. One example: the 20^th century claim that “homosexuality is unnatural, and if it is tolerated, the human species will go extinct as procreation will stop.” This claim was made by opponents of the so-called gay liberation movement, many of them religious conservatives, but using the language of science. And after all, for many years, scientists had been claiming that homosexuality was a medical disorder that must be cured.

The really weird thing about the end-of-the-species claim, if you think about it, is that it presumed that if same-gender sexual activity were tolerated, then nobody would ever have mixed-gender sex again. Why would people who presumably happily identified as heterosexual think something like that? Well, it’s because each of the precepts of the Ideology of Natural Sex are seen as inextricably linked. The purpose of sex is reproduction; this requires men and women; people must accept their assigned gender roles. Allow two men or two women to have sex, and the other precepts will fall as well. Society as we know it will collapse, and in fact, we’ll die out as a species as we won’t reproduce anymore. Our nature will be destroyed and humans will suffer an apocalypse.

Today, in the early 21^st century, intersex and trans issues are coming to the fore. And the same patterns emerge, as they have in the past of which we are unaware.

From science and medicine, what we see is the framing of bodies, identities and behaviors that fall outside the Ideology of Natural Sex as disorders to be classified and treated. The goal is to restore the “natural order” through techniques developed by science: eugenic programs, surgical “normalization,” and psychotherapies. Consider intersex status right now. There is a growing social movement of intersex people to put an end to the nonconsensual genital surgeries that have been imposed on intersex children since the 20^th century. But doctors are extremely resistant to this movement. Living with a sex-variant body is presented by doctors as a fatal condition. It will lead to social death, which may lead in turn to suicide. Without a body that conforms to binary sex expectations, it will be impossible to find a mate, so even if one lives, it will be an empty life, a painful one full of strange nonconforming behavior and self-loathing. Surgeons claim they are compelled to continue intersex genital mutilation to preserve life and quality of life, dismissing the cry of intersex advocates that these “treatments” in fact degrade their quality of life.

From the religious side, what we see is an assertion that Natural Law created by God must be affirmed by all human laws. To do otherwise is not only an offense to God, but will destroy humanity. Speaking recently of the supposed danger of the trans rights movement, Pope Francis said, "We are experiencing a moment of the annihilation of man as the image of God." Natural law, understood as decreed by God, requires binary sex, and that gender conform to that binary sex. Worldly laws must not be enacted to acknowledge and support people's gender identities. In fact, say religious conservatives, to speak of gender at all is to offend God. There is only sex, and never before have humans suggested that one also has a gender identity and should express its inner truth! (The fact that gender identity recognition and gender transition are as old as humanity is a history that we’ve already seen has been erased by the “natural law” framing.) And fascinatingly, the Catholic church evokes science to “prove” its position. Sex, the Church states, is determined by DNA. DNA, unlike clothing or hormones or genitals, cannot be changed. Thus, one can never change one’s “true” sex. Gender transition is a wicked lie, a deception, and according to Pope Francis, as dangerous to humanity as nuclear weapons. It must be stopped and “nature” defended.

So science and religion walk arm in arm, trumpeting the ideology of the Natural Law of Sex. This gives everyone in the general population something to latch onto in framing the oppression of some group as necessary and good. Are you a socially conservative religious person who finds trans people disgusting? Claim that the statement “male and female created He them” in Genesis is not a generalizing poetic phrase but a morally prescriptive statement that must be socially enforced. Are you a radical cis feminist who disdains the Pope, but shares with him disgust for trans people?  Claim that DNA determines sex, that gender identity is a delusion, and that trans women are thus sick male threats to the safety of “biological women.”

There’s something for everyone.

What makes the Ideology of Natural Sex so powerful is that, like all deeply effective belief systems, it is so taken-for-granted that it is like water to a fish. Most people are unaware of the very concept of a sex/gender ideology. And therefore, merely to ask the question “How many genders are there in your society?” strikes them both infantile and very offensive. Show them a drawing of intermediate genitalia and they gasp in profound shock. Present them with a visibly trans body and they laugh or gag or feel incited to commit violence.  These strong negative reactions occur because having your ideology challenged is bad enough, but when you didn’t even know it was an ideology in the first place, it makes you question everything. And sadly, most people don’t want to do that at all.

But we have to do it.

If we truly believe in science, in a rational world where we look objectively at what is, rather than impose our beliefs onto reality, then we need to reject the Ideology of Natural Sex. We need to see the reality of the sex spectrum and stop framing intersexuality as a rare disorder that somehow violates natural law. We need to understand that different societies have divided the sex spectrum up into different numbers of social sexes, and that binary sex is no more or less arbitrary than trinary or quartic sex systems. We need to give up the silly idea that sexual interactions only serve reproductive purposes, when it is massively evident in nature that nonprocreative sex is everywhere in social species. We need to become aware of the omnipresent world history of gender transitioning, and let go of the myth that not until the 20^th century introduced modern surgical transition procedures did “real” gender transitions occur.

And if we truly believe in religion, then we must adhere to the precepts of compassion that all religions teach, and stop using religion to oppress minorities or spread hate.

Intersex people, trans people, queer people, lusty women. . . we don’t violate natural law. In fact, we’ve always been a part of human nature. And accepting and respecting us as we are will not cause the end of the world. At all.

It could, however, spell the start of a kinder and fairer world. So please, just let go of the Western Ideology of Natural Sex.

When Intersex People are Collateral Damage in Transphobic Battles

As intersex people, we have to deal with a host of issues because our bodies lie between the socially-expected bodily norms of male and female. Our bodies are treated as disordered, as problems to be solved by the medical profession. Doctors and people on the street alike treat intersexuality as freakish and fascinating, both intriguing and repellent.  Our bodies are surgically altered without our consent as children, and we must live with the lifelong aftereffects of limited sensation and ongoing genital atypicality. We are taught to view our differences as shameful and to keep them secret. Very often we hesitate to enter romantic relationships, fearing rejection because our bodies challenge the very ideas of heterosexuality and homosexuality through which most people understand themselves. We may be pursued, however, by sexual fetishists.

It's a lot to deal with, for many of us.  And then, on top of the challenges we're already facing, we find ourselves targeted by people who don't even recognize we exist: transphobic activists.

Today, trans gender people are making some social progress in securing protection from discrimination--but they face resistance. A central tactic of those who oppose trans gender rights in the U.S. is to propose legislation prohibiting trans people from using particular gendered facilities such as bathrooms, changing rooms, or locker rooms. Those proposing the legislation argue that the new law will protect  (cis) women and children from being harassed, attacked by sexual predators, or made to feel unsafe or uncomfortable.  Now, we should note a couple of things--first of all, proposed laws like these are aimed at trans women and girls--not even trans men, let alone intersex people. Those drafting the legislation clearly aren't imagining the situation in which an intersex teen using a school locker room is greeted by uncomfortable stares, or imagining that a trans man using a men's bathroom will make cis men flee the facility in fear. The proposed laws are transmisogynist: aimed at trans women, who are framed as "really men" who are some sort of sexual perverts. Secondly, sexual harassment and assault are already illegal, in bathrooms or elsewhere, so the only thing the proposed legislation actually accomplishes is to transform informal policing of the ideology of the sex/gender binary into formal policing. Those whose bodies don't clearly conform to expectations for what a woman's body is "supposed" to look like now become literal criminals.

But the drafters of transphobic bathroom laws run into a problem. People police binary sex/gender norms all the time, but they do so informally. The drafters have to come up with objective language to put into their proposed legislation.  Early efforts banning people from using bathrooms tended to require a person challenged upon entering a gendered bathroom to show ID with that gender listed on it. Of course, as part of the process of gender transition, large numbers of trans people have the gender listed on their driver's license or other ID changed. So the transphobic activists proposing these laws switched to using language of "birth certificate sex." But in some states, people who medically gender transition are able to change the sex listed on their birth certificate.

And that's why recent proposed bathroom-exclusionary language has moved to requiring people who use gendered facilities to have a matching "biological sex at birth" or even matching binary genotype of XX or XY.

Now, all forms of sex-policing bathroom bills, while aimed at trans people, are bad for at least some intersex people who are ipso gender (that is, who identify with the binary sex they were assigned at birth). An intersex person may be assigned female at birth, and identify as a woman, but have substantial amounts of bodily and facial hair, leading her to have to deal with a lot of sex and gender policing. Such an individual is likely to face many of the same issues of bias and outrage that visibly trans women encounter when they try to use women's bathrooms.

But the bills making it illegal to use a single-sex bathroom unless one was born with the anatomy expected for people of that sex basically declare it illegal for intersex people--by definition born with bodies that are neither male nor female--to use gendered bathrooms at all.

Further, the Texas law basing bathroom use on genotype specifically states, "If the individual's gender [sic] established at the individual's birth is not the same as the individual's gender [sic] established by the individual's chromosomes," that their gender for bathroom-use purposes would be determined by chromosomes. Just think about what this means for, say, a woman with CAIS, complete androgen insensitivity syndrome. She is born with female-typical external genitalia and assigned female at birth. She's raised as a girl and identifies as one.  At puberty she develops breasts, but no menstrual cycle, and it's only when tests are done to determine why that she finds out she has XY chromosomes, no uterus, and internal testes (whose testosterone her body cannot respond to). The Texas law tells her she must use the men's room, because her Y chromosome trumps her physical appearance, genitalia, birth certificate, sex of rearing and gender identity.  This law is telling her she is "really" a man.  If she uses a women's room, it's a class-A misdemeanor for which she could get a year in jail. And if her employer finds out she has CAIS--something that her medical records reveal--well, then, if he lets her repeatedly use the women's bathroom at work, then he is committing a felony, punishable by two years in jail and a $10,000 fine.

So what should we as intersex people do about this?

It's very unlikely that we are the intended targets of these proposed laws--we're just collateral damage. Some may argue that few ipso gender intersex people look androgynous enough to trigger enforcement--that nobody's going to call the cops on us.  But some of us *are* physically androgynous and genitally different and regularly have to cope with gender-policing. Furthermore, it's now becoming popular to have provisions in bathroom-panic legislation that either put employers and facility owners at risk of fines, like the Texas law, or give third parties who see a person of the "wrong sex" in the bathroom, locker room, etc. the right to sue the school or business and get guaranteed recompense. For example, high school students in Kentucky who see a student whose sex is "incorrect" in the bathroom or locker room would be entitled to sue the school for $2500 for each time they catch the student in the facility.

Imagine what could happen to an intersex high school child in Kentucky who has a visible genital difference under a scheme in which classmates could earn $2500 each time they complained they saw their "incorrect" genitals.

These proposed laws give people a financial incentive to scrutinize our intersex bodily differences and to report them to authorities. They give employers and businesses a financial incentive to increase their sex and gender policing, lest they face a fine.  They are a bad thing for us.

Now, one solution some might propose would be to educate transphobic legislators about the difference between intersexuality and transsexuality. We could ask that the laws being proposed include exemptions for people born intersex, based on the presumption that if transphobic lawmakers understood what intersexuality is, they would express sympathy rather than bigotry toward us.

I think not only is this naively optimistic, but that it would be a terrible mistake.

Now, I acknowledge that relations between the intersex and trans communities are not always the best.  I validate the complaints of many intersex people that trans people are quick to use evidence of our existence to try to break down the ideology of immutable binary sex/gender--but slow to act as allies, and understand our community's needs, and include us appropriately in their antidiscrimination regulatory proposals.

But I believe we must consider trans issues to be our issues.  Firstly, because the portion of the intersex community that gender transitions is much higher than the proportion of nonintersex people who gender transition. There are a lot of intersex trans folks--like myself, like my spouse--who are active in the intersex community.

Beyond that, it's rational for us to stand side by side with nonintersex trans folks in battles like these precisely because we are impacted just as they are. So many people in our society think intersex people are trans people that transphobia constantly impacts us, even those of us who are ipso gender rather than trans.  We are fighting against our own mistreatment.

Ultimately, I believe that even those of us who, pragmatically speaking, are likely never to be personally impacted by bathroom-panic laws--because our bodies and genitals and birth certificates and chromosomes and gender identities all fortunately align and our intersex differences are not visible--all of us should stand against transphobic laws. We should do so as ethical human beings, opposed to all inequality and bias, not just those forms of bigotry that negatively impact us personally.

Now, all that said, I need to have a word with our trans allies, with whom I hope our community will stand. And that is: please, nonintersex trans people out there, don't try to use us without including us. Though we're taking collateral damage, we're not the primary targets in the bathroom wars.  If you think that femme CAIS women would make great mouthpieces for delivering talking points about how cruelly these laws would impact "innocent" women like them (and I've seen the calls and requests), fine.  But don't use members of our community or the very idea of intersexuality as a way to win your battles--without making an equal effort to fight for our rights, especially the right of intersex people to be free of unconsented-to surgery.

With all these things said--intersex and trans siblings, let's stand together against sex and gender policing laws.

Trans-Exclusionary Radical Feminists and Intersex Experience

Recently I spent several days in a public internet group for "gender critical" people, after a few intersex friends voiced some positive things about this line of thinking.  Feminists who call themselves "gender critical" are a controversial bunch, but their critique of the term "cis gender" had caught the interest of some intersex people I respect.  The term "cis gender" is an awkward one to use in the context of intersex people, which was the subject of my last blog post.  So I wanted to approach this branch of feminism with an open mind, and see if there was theorizing or political advocacy I could use in my intersex work.  The group I joined promised respectful listening to people of varying beliefs, and banned personal attacks, so I had high hopes.

My hopes, I'm afraid, were naive.  The group turned out to be completely dominated by "TERFs," trans-exclusionary radical feminists, and when it came to intersex topics, not people I would consider good allies in the least.  So, since I know there are other intersex advocates who've presented "gender critical" politics in a positive light, I wanted to write a post about why I consider this a bad idea.

First, since I suspect that a good number of readers may be unfamiliar with the terms "gender critical" and "TERF," I will present an overview of the beliefs involved, in the form of a handy numbered-list primer.

A TERF Primer

1.  Calling themselves "radfems" or "gender-critical feminists," and named TERFs by radical-feminist-identified people who are not transphobic, these are cis women who oppose the inclusion of trans women in feminist organizations, women's spaces, and female facilities.  TERFs do not describe themselves as cis women, however, but as women-born-women, natal women, or (unmodified) women.  They assert that the terms "TERF" and "cis" are slurs.  Generally they just refer to one another in discussions as "feminists" and as "women," as if anyone who is a feminist would agree with all that they say, and as if their female status should go unmarked, as the normative or "real" female status.

2.  Trans-exclusionary radical feminists believe that sex is a natural binary, innate and immutable: men have penises, women have vaginas and uteri.  They note that gender is a relationship of power, in which men seek to control women's uteri, reproductive capacities and lives.  The ultimate expression of this patriarchy is the use of the penis to rape.  As a result, "gender critical feminists" make the strong claim that anyone who denies that sex is a binary and that genitals determine gender is ignoring the terrorizing of (natal/cis) women by rapists.

3.  TERFs argue that sex cannot be changed: trans women are really and eternally men, and trans men are really and eternally women.  Identifying with a gender that doesn't match one's genitals is a delusion or mental illness.  The phrase "gender critical" denotes being critical of (or more bluntly, rejecting) the concept of gender identity--most especially the fundamental precept of trans gender advocacy, which is that when gender identity and legal sex conflict, this provides pragmatic and ethical justification for a change of legal sex.

4.  TERFs deny that they are transphobic, and say they have compassion for men under the delusion that they are women, which they present as equivalent to believing one is really a horse or a space alien.  Dysphoria with one's body, they point out, is not a special characteristic of trans people, but a near-universal, and the solution is to accept one's body.  Accepting one's body means accepting that one cannot call oneself a woman while having a penis.  (Nor can sex be altered through genital reconstructive surgery , which is a radical mutilation to no purpose, as genes can't be changed and binary sex is essential.  But in most of the discussion threads I read, it was assumed that trans women all have penises, making them dangerous, as penises are rape weapons.  In fact, I've never read the word "penis" so often outside of a urology blog.)

5.  TERFs are not just binary sex essentialists, they also have a theory of gender socialization.  Their vision of gender socialization is bleak: boys are socialized to dominate, control, and rape women; girls are socialized to submit to this and embrace their oppressors and call this "femininity."  Clearly this is bad, and feminism is a movement of (natal/cis) women that teaches women to recognize and resist this programming.  Men, however, are presented as inevitably and eternally shaped by their socialization into patriarchy, as it advantages them.  Trans women are men, and while they may claim they do not enjoy being treated as men, this just illustrates their blindness to their own privilege.  Trans women are inevitably socialized to try to control "natal" women, as evidenced by their belief they should be able to force cis women into supporting their gender delusion and treating them as sisters.

6.  Thus, this conclusion about trans people: trans women are confused men, fetishists of the feminine, who are prompted by their male socialization to seek to control women--in this case, due to their delusion that they are women, to control feminism and women-born-women's spaces.  Trans men are less of a problem, since they pose no threat to anyone, lacking both penises and socialization into the role of the oppressor.  Trans men are just sad: women who don't understand that it's ok to be a butch woman or a lesbian, victims of Stockholm syndrome identifying with their oppressor.  Women who are deluded into thinking they are men should be pitied and exhorted to return to the fold.  But men who delude themselves that they are women are a serious problem.  They must be stopped: with exclusionary policies, taking back feminism from a trans-obsessed trend; by fighting antidiscrimination clauses that would let trans women and girls use women's bathrooms; through telling the world that supporting trans children in their identities is child abuse.

7.  Feminists who are trans allies and transfeminists counter each of these points.  They state that sex is not a natural binary, but naturally a spectrum (i.e., intersexuality happens).  They point out that many cis women lack uteri, yet are still considered women by everyone, even TERFs.  They note that gender socialization is complex and variable, that it is shaped by the gender with which one identifies, and that acknowledging both these facts is in no way a denial of the reality of patriarchy.  They assert that it is important, however, to acknowledge the intersectional nature of marginalization and privilege, and speak not just of patriarchy but of kyriarchy, taking into account race, age, sexual orientation, (dis)ability, and other dimensions along which power is distributed.  And one of these dimensions is the axis of cis privilege and trans marginalization.  Trans women--particularly those who are poor, of color, and/or have a disability--suffer huge levels of social stigma, violence, employment discrimination, etc.  Cis women need to acknowledge that while they are marginalized as women, they are privileged as cis people.

8.  TERFs respond to trans allies with anger.  They say trans allies are dupes, following a trend that counters basic logic, biology, nature, and the English language when they accept the idea that a person with a penis can be called female.  (Quoting the dictionary is popular to "prove" that genitals determine gender.)  They discount all the statistics about violence against trans women (and to a lesser extent trans men) as manufactured and overstated.  They assert that a woman can never oppress a man, and trans women actually being men, "natal" women cannot oppress them.  The TERFs repudiate being termed cis gender, equating the term "cis" with gender-conforming and unenlightened femininity, and regularly linking it to the violent phrase "die cis scum," which they assert is the core sentiment of men who think they are women, as if trans women's goal is to kill off all cis feminists so that trans women can have every feminist organization that exists all to themselves.  Finally, they equate acknowledging cis privilege with asserting a belief that women are not oppressed.

Intersex People and "Gender Critical" Politics

It's clear that I view TERFs, in a word, as bigots.  Their mission is to discriminate against and exclude a marginalized group.  I hoped I might encounter something less stark and more nuanced in the "gender critical"internet discussion group I joined, since some other intersex advocates have had some positive things to say.  But that's not what happened, and a couple of days spent reading and attempting to have conversations left me feeling depressed and sullied.  There were a few positive moments, but they were vastly outweighed by slogging through a lot of LOLing about how stupid a person must be to think they can call themselves female when they were born with a penis.

So, my first question is, why have a few intersex friends had anything good to say about TERFs?  I think I can point to a few things.

1.  The phrase "gender critical" sounds appealing.  My intersex friends are critical of the way sex and gender are understood and enforced in the contemporary West, since this involves unconsented-to surgery performed on intersex infants' genitalia with lifelong ramifications that can be quite negative (loss of genital sensation, loss of fertility, loss of a source of natural sex hormones, and sometimes assignment to a sex with which the child does not grow up to identify).  A group that says they critique gender from a feminist perspective certainly sounds like it would make a reasonable ally.

2.  Intersex people are often uncomfortable with the application of the terms "cis" and "trans" to intersex experience.  The terms apply very poorly because they presume that physical sex is binary (even if gender identities may be nonbinary).  That is, if a person is born genitally intermediate, surgically assigned female, and grows up to identify as a woman, is she "trans gender" because she was surgically genitally altered to become female, or "cis gender" because she identifies with the sex she was assigned at birth?  Either term winds up misrepresenting something about her experience.  (I've suggested the term "ipso gender" in my last post as an alternative.)  In any case, TERFs reject the term cis gender, and this may appeal to an intersex person frustrated with this terminology.

3.  In recent months, there have been a series of "mainstream" articles and online posts in which TERFs' positions have been sympathetically expressed.  For example, one article mentioned by an intersex friend critiqued the term "cis privilege" by caricaturing it as meaning "having a female body is a privilege."  Clearly this is false: because of patriarchy, female bodies are sexualized, framed as weak, and subjected to surveillance.  Tons of cis women don't enjoy getting periods or feeling constantly at risk of an unwanted pregnancy.  Having a female body is not a privilege--but it is also not how trans advocates define cis privilege at all.  Trans people actually define cis privilege as "the benefits one derives from being seen as a 'real' and 'natural' member of one's identified sex" (lack of public scrutiny of one's primary and secondary sex characteristics, being able to use a public bathroom with relative ease, having an ID that matches one's identity, etc.).  Nor do trans people deny, as the linked article claims, that cis people also suffer from gender policing.  Someone who identifies as a woman yet who is very butch can suffer from bathroom panic, and a male-identified person who is quite feminine may face a great deal of street harassment.  That is why trans advocates always fight for laws banning discrimination on the basis of gender identity or gender expression.  But if you read the linked article and took it at face value--why, the arguments of trans women sound regressive and ludicrous and enforcing of binary gender stereotypes.  Trans women are telling "natal" women their privilege is to enjoy being pretty and silent and submissive and having lots of babies, says the author!  If that were true, transfeminists really would be revealed to be patriarchal oppressors in disguise.  Only. . . it's not true.  It's a false characterization on par with saying that "feminists are man-haters."

OK, now we have some ideas about why intersex people might think that "gender critical" camp could be reasonable allies for intersex people.  The next question to address is what did I actually find TERFs to say about intersex issues when they were raised in group discussions?  Clearly the "gender crits" aren't trans allies, but are they nonetheless intersex ones?

The first thing I really want to acknowledge is that it's not all bad.  A couple of points came up where "gender critical" positions did align with intersex advocates'.  Most centrally, since TERFs believe that the "natural" sexed body should be accepted rather than medically altered, a good number of commenters were opposed to performing genital surgery on intersex infants, seeing it as mutilation.   That's a good thing.  And secondly, when I posted about Dutee Chand, an athlete who has been excluded from international sports due to sex-policing of her natural levels of testosterone, I found that at least in situations in which a person was born with vulva, raised as a girl, and has XX chromosomes, the TERF posters believed she should be allowed to compete in women's sports despite having testosterone levels that were considered "male."  Also good!

Well, those positions sound heartening!  Why then do I say that the "gender critical" partisans are not good allies for the intersex community?  Because of these numerous other positions of theirs:

1.  There was a total consensus among the trans-exclusionary feminists that sex is naturally a binary.  The fact that people are born sexually intermediate was somehow said not to undermine this assertion, because intersexuality was presented as a disorder, and, I was informed, "you can't take a disorder and call it a sex."  All intersex people were held to have a true binary sex.  While doctors shouldn't perform cosmetic genital surgery, TERFs asserted they should examine the infant and assign them to the correct binary sex on their birth certificates.  I was told that the correct sex would be based on capacity to reproduce in the "very rare" situations in which that would be possible without surgery, and otherwise on genes.

2.  Removing sex-markers from birth certificates generally, or making a preliminary sex marker amendable at will at maturity to M, F, or a nonbinary category--as suggested by intersex advocates--were thus framed as crazy.  It could confuse the child into believing they are members of a third sex, while "real" intersex people identify as women or men, discussants claimed.  It was presumed to be bad for intersex children, while encouraging trans genderqueer fantasies.  Since TERFs see gender identity as a sort of delusion or myth, the idea that families and society should allow the child to mature to develop and assert their own gender identity (male, female, or something else) is basically incomprehensible. 

3.  Nobody on the site at the time I was on it seemed aware what the result of the sex assignment scheme they described would be.  For example, people with CAIS, born with typical vulvae and developing female secondary sex characteristics at puberty if unaltered by gonadectomy, would be understood as permanently and naturally male, being infertile and having XY chromosomes.  Yet CAIS is often not diagnosed until late childhood or puberty, so either CAIS teens would be forced into gender transitions--a process the "gender crits" frame as impossible--or the TERFs would have to accept XY women.  Meanwhile, people born with a phallus fully masculinized by CAH would be permanently assigned female based on having XX chromosomes, while left surgically unaltered.  Given that the most central tenet of TERF politics is that a person with a penis cannot be female, this is a particularly strange outcome.

4.  I was surprised to find myself repeatedly informed that "intersexuality is a derail" when I raised concerns in conversations.  One reason for this is that being born intersex was framed as vanishingly rare.  Basically this argument held that half the population is made up of "natal women" under threat from men trans-deluded into thinking they have a right to enter women's spaces, while intersex issues only impact a handful of people, and concerns about a minor edge case shouldn't come to dominate a discussion about masses of women-born-women.

5.  The main reason I was told that TERF group members were "far beyond the point of reasonable frustration or tolerance for the intersex derail in conversations about gender identity" is that it was supposedly "only ever brought into conversations" as a distractor by men (that is, trans women) trying to deny the reality that genitals determine immutable binary gender, that "natal" women are oppressed rather than privileged, and that trans women are privileged rather than oppressed.  The fact that I, who am intersex and not a trans woman, was the person raising intersex issues was glossed over.   Intersexuality is presented as a straw man issue beloved by trans women.

6.  Another thing I was told is that most people claiming to be intersex are actually trans gender pretenders.  Now, I as an intersex advocate have spoken before about there being an issue of "intersex wannabes"out there, a problem for our community when they present physically-impossible stories--such as having been born with a full set of female reproductive organs and a full set of male ones--that contribute to disinformation.  But I do not appreciate being told that most people who say they are intersex are liars, and that the "tiny minority" of people who actually are intersex are being used by these men-who-caricature-women, proof that real intersex people should revile trans people.  I can make my own determinations about the true prevalence of intersex status, and who is supporting or exploiting me.  Not to mention that asserting that most people who identify as intersex are in fact lying itself contributes to disinformation about our community.

7.  The main situation in which intersex concerns were actually treated as relevant was in the context of discussions of trans-identified children.  (A particularly overwrought conversation in the group discussed an article which bore the blaring title "Toddler Aged 3 Assessed for Sex Change at London Clinic," which actually just reported that a 3-year-old was assessed for gender identity issues, not that the child was offered any sort of hormonal or surgical treatment.)  A claim made in the discussions of trans-identified children was that for parents to "indulge" this "fantasy" by bringing them to a clinic to be diagnosed, changing the pronoun they used to refer to the child, and/or having the gender marker on their ID changed was analogous to forcing genital surgery on intersex children, and thus a human rights violation that should be banned.  I don't see an analogy at all, but rather an inversion: forced genital surgery performed on infants violates their autonomy, while validating a child in their gender identity supports the child's autonomy.  I see TERFs appropriating intersex concerns about unconsented-to genital surgery to advance their goals.

So: I followed a recent suggestion that "gender critical" politics might be useful to intersex people, and spent several days reading posts and participating in a group for "gender critical" partisans.  What I found was something that left an awful taste in my mouth: a lot of transmisogyny, a denial of the lived reality of trans people of all genders, and an insistence on an immutable sex binarism that frames intersex people as disordered.  I was told that most people who say they are intersex are trans pretenders, using a tiny minority to advance their nefarious goal of insisting that gender identity should be respected and genitals treated as nobody's business other than the person bearing them and their intimate partners.  And I found the intersex community's concerns being co-opted to vilify parents who support their children in identifying with a gender other than that on their birth certificates.

They may call themselves by the intriguing moniker "gender critical," but I believe these trans-exclusionary feminists make very poor allies for the intersex community.