A Rant About Surgeries

Surgeons are constantly trying to "improve" intersex surgeries. They see intersex complaints as a challenge to improve their technique, blind to the pain and suffering they are causing.

Granted Intersex surgery has come a long way from its origins in the 50s which consisted of amputating the clitoris/penis (whatever, it's really the same organ). However the outcome is still just as terrible. No doctor can dispute that when you cut someone, your body patches it with inflexible, unfeeling scar tissue, and in an area with such high nerve concentration, some nerves inevitably get severed as well. As a result most people who have undergone this surgery are rendered completely inorgasmic, the victims of social fears and medical hubris.

This is not to say that I am totally opposed to surgery. Once an intersexual is old enough to make an informed decision, and want to bring their genitals more in line with their gender identity, they should have every right to do so, and I wish them luck with that. However it must absolutely be their choice, and not their panicky parents. However most intersexuals (at least the outspoken ones, myself included) have a somewhat ambiguous gender identity and are very hurt and angry about what was done to them, feeling that their ambiguous genitalia was better suited for their gender identity, but had them irreversibly taken away.

Even if the surgery was perfect (they often don't work very well anyways and usually require follow up surgeries) with no loss of sensation, and identical appearance and functioning compared to "normal" genitals, I would still say it is unethical to operate. Informed consent must be given by the individual. Genital "correction" is not like fixing an infants club foot or cleft pallet, it has lifelong consequences for the individuals sexual enjoyment and determines how society will perceive them. As such, parental consent should not be enough to authorize such a procedure.

Not only in there a problem of consent, there is also a problem of gender. Infants cannot express a preference for one gender or the other. If the doctors and parents make a mistake in their gender assignment it is far worse if they have surgically removed the parts that were desirable and would have made the transition much easier thus increasing anguish in an already emotional situation.

I also question why such surgeries are needed. Granted some situations, like mixed tissue gonads which go cancerous 98% of the time need to be removed. However, infants are not experiencing any confusion or emotional pain over their genitals. It's everyone elses comfort level that is being considered and not the one person who will be most affected. It is the heteronormative expectations of society that ultimately win.

My intention here is not to demonize anyone. Both the doctors and parents have totally charitable intentions. Parents are concerned that their child will be bullied and harassed and consider themselves a freak, not to mention the old panicky parent concern with locker rooms. These are all valid concerns. I think the Intersex Society of North America offers the best solution. Without operating, raise the child with one gender so they can function in society and hopefully avoid social ostracising. However they should also be open to the possibility they may change, and when they are old enough, let them make a decision about what they want. Suicide is also a major concern, the rate is very high for intersexuals. Doctors and parents think that having unambiguous genitals reduce psychosexual confusion and depression and reduce the rate of suicide. This argument does not hold water. The few case studies and follow ups out there suggest that unwanted surgery actually increases the chances of suicide by increasing the sense that you were so freakish, ugly, and unacceptably abnormal, that you had to be changed.

In short no one should be subjected to nonconsentual, purely cosmetic surgery, which, I would argue, is a breech of the Hippocratic Oath. I urge all my readers to inform themselves on this issue and to speak out about it. On behalf of the intersex community, I thank you for listening to this rant (that is already more then most of the medical establishment has done, most of them are too embarrassed, I think, to address our complaints head on).