Tuesday, September 30, 2014

F is for Foreskin

Today F is for Foreskin, or the removal thereof.  In the United States (my home country) circumcision for baby boys is routine and almost universal.  The American Academy of Pediatrics, and the American Medical Association recommend it for all baby boys.  For Muslims and Jews circumcision is done for religious reasons.  Secular reasons for circumcision are getting hazier but revolve around hygiene and disease prevention, and historically, to prevent masturbation.  Phimosis (where the foreskin does not fully retract) is the only medically therapeutic reason for circumcision, and even then, there are nonsurgical alternatives.  

The policy of non-therapeutic, non-consensual, secular circumcision is getting quite controversial.  The intactivists (intact activists, clever!) use much of the same arguments that intersex activists use.  They claim any non-therapeutic procedure, especially an irreversible one, cannot ethically be consented to by anyone other than the patient.  They feel non-therapeutic, non-consensual, secular circumcision violates the baby’s bodily integrity (sound familiar?)  Some anti-circumcision activists extend their view of bodily integrity to oppose intersex surgery and female genital mutilation (FGM).  Laws in most western countries, including the United States, protect baby girls from FGM, but don’t protect baby boys or intersex children.

It is very controversial to compare circumcision to FGM, once euphemistically called “female circumcision.”  Circumcision does not alter sexual functioning or overall health, FGM and intersex mutilation does.  Thus I do agree that non-therapeutic, non-consensual secular circumcision is not ethical and should be stopped.  I am also glad the anti-circumcision crowd is giving intersex issues much needed exposure, but I disagree that the two are really comparable.          

Thursday, September 25, 2014

F if for Fertility

Today F is for fertility.  Common wisdom is that intersex conditions render the person sterile, but this is not entirely true.  Most intersex conditions vary considerably in where, and how much, ambiguity there is in any specific person.  Many intersex people are sterile, but many could give birth, or father children.  Often these conceptions, pregnancies, and births are quite difficult, but in some cases it is possible.  Ultimately how fertile an intersex person is should be determined on a case by case basis.   

Frankly the common practice of removing the gonads of intersex people sterilizes more people than the conditions themselves.  To be fair, there are good reasons behind removing the gonads.  There is a good chance mixed tissue gonads will become cancerous.  This cancer risk could be monitored, there is no need to take currently healthy organs.  This unnecessary sterilization is just further medical abuse of the intersexed.  As I mentioned earlier, many, if not most, intersex people are sterile, or have diminished fertility.  That being said, if they could become biological parents that option should be there for them when they reach adulthood.  I believe that keeping options and choices open for the intersex patient should be the main goal for their care so they can make the right choice for them.  That this is not considered a breach of the Hippocratic Oath is astounding.

Many people (especially heterosexual, cisgender people) consider reproduction a key part of their gender identity.  They might consider non-consensual sterilization to be psychologically devastating.  For some people it might be.  I can only discuss this from my own experience.  I had my gonads removed as a young child and chose to have a hysterectomy in my mid-twenties.  My parents were open and honest with me growing up.  As a result I grew up knowing that I was sterile and it became part of my self perception.  With no basis for comparison, it is all I know, and I accept this.  Honestly, to discover at this point that I could biologically have children would be far more disturbing then hearing I can't.     

Thursday, September 18, 2014

E is for effeminate/F is for femininity

For the perfect buffer between  E and F, I have a concept that can be called by an E word or an F word, effeminacy or femininity.  Both words refer to the nature, attributes, behavior, mannerisms, style, and gender roles associated with women.  When referring to a woman with these traits, feminine is used, when referring to a man they are called effeminate.  This is a very broad topic and I am bound to leave a lot out so please bear with me.

I’m sure you all know this, but I would be remiss if I didn’t define and cover what is considered feminine/effeminate.  What is considered feminine/effeminate depends on social context, culture, and time (Elizabethan men wearing lace was considered masculine, for example).  That being said, gentleness, empathy, sensitivity, caring, compassion, nurturing, deference and sexual passiveness are usually considered feminine/effeminate personality traits.  To what extent these traits are inherent or learned through socialization is a matter of great debate.  Presentation and appearance such as long hair, cosmetics, female clothing, and an emphasis on physical beauty are almost always considered feminine/effeminate.  The professional feminine social role has traditionally been confined to the home or the nurturing/helping jobs like nurses, teachers, and secretaries. 

Effeminate men are usually far less accepted then masculine women.  Effeminacy is usually pejorative and implies passivity, and weakness, and homosexuality.  Saying gay men are effeminate is inaccurate.  Historically camp, drag, and swish have been part of gay culture; but so are Castro Clones and Bears, who are decidedly masculine.  Men who are interested in fashion have been called dandies and fops but those are usually labels they call themselves whereas, others call a man effeminate.           

Second wave feminists considered femininity to be an artificial social construct to keep women subordinate and objectified since power and authority are considered very masculine.  Modern, “lipstick feminists” counter that this devalues the feminine identity.  They claim the symbols of femininity are not inherently subjugating and can even be empowering.  Julia Serano writes (and I agree) that because society is sexist, femininity is seen through a male lens and interpreted as being less important or frivolous.  She feels that equality of the sexes will never be achieved until femininity is empowered rather than despised (including by some feminists).  She also claims that parts of femininity and masculinity are inherent but not biologically derived, they precede socialization and supersede biological sex.    

What does this have to do with intersex?  There are certainly feminine and masculine intersex people.  Like everyone, we have the right to identify and live as we see fit.  If you believe gendered behavior is biologically determined you would conclude that most intersex people must be fairly androgynous.  Feminine (or masculine) intersex people obviously disprove this.  That being said, I object to intersex people being used to prove some gender ideology, its dehumanizing.  Leave comments, let me know if I missed something important about femininity/effeminacy.      

Tuesday, September 16, 2014

E is for Estrogen

Our E word for today is estrogen.   There are actually three female sex hormones in humans, estradiol, estrone, and estriol which are all estrogens.  Estradiol is the most important one and has the physical effects commonly associated with “estrogen”.  These effects are:

~ breast growth
~changes in fat placement
~ strengthens bones
~ strengthens vagina and uterus
~ lessens melanin in skin (ever notice how most men have slightly darker skin than most women?)
~ stimulates growth of endometrium and thus causes menstruation
~ stimulates luteinizing hormone which causes ovulation (birth control pills cause a permanent surge of estrogen to mask this and thus prevent ovulation)
~ works with testosterone to increase sex drive
~Changes levels of serotonin and endorphins in the brain, causing the psychological and behavioral differences between men and women

As most people know, both men and women produce estrogen in their gonads and adrenal glands.  The balance of sex hormones is vital for a fetus to develop into a male or female.  Many intersex conditions result from their hormones being off or being unable to react to hormones.  Don't worry men, I will talk about testosterone when I get to T so stay with me as I blog my way through the alphabet.  

Tuesday, September 9, 2014

E is for Eunuch

Out first E word is eunuch.  Eunuchs are usually castrated men.  They were often used in ancient cultures to guard harams and the royal family and in important government jobs.  They were trusted because they would keep their hands off the women of the haram or royal family and couldn’t father their own lineage to challenge the king.  Castrati singers were castrated before puberty to sing the high notes in choirs because women were not allowed to.  

The ancients actually had a much broader definition of eunuchs.  The Bible says “there are eunuchs who were born that way, and there are eunuchs who have been made eunuchs by others, and there are those who choose to live like eunuchs for the sake of the kingdom of heaven” (Matthew 19:23).  In his Generation of Animals, Aristotle says procreation requires both the mental faculty and anatomical parts to do so.  By this definition homosexuals and asexuals who lack the mental faculty to procreate are eunuchs.  Roman emperor Justinian I even used the Aristotelian definition of eunuchs in his laws as “one with no generative power, an impotent person, either by nature or castration.”

By this broader definition many, if not most intersex people are “eunuchs who were born that way”.  Many intersex conditions result in sterility and we usually have our gonads removed.  There are also higher cases of homosexuality and asexuality (or at least celibacy) amongst intersex people.  I have occasionally used eunuch to describe myself.  I kind of like it because it is a gender nonconforming identity and also gives a nod to the genital mutilation I underwent (for better or worse it’s a part of me).  Eunuchs were prominent members of their societies, should we reclaim this title?  Leave comments, let me know what you think.

Thursday, September 4, 2014

Intersex Psycho

This is a buffer between D and E.  Join me as I continue blogging through the alphabet next week.  Today I am going to talk about an occurrence that is happening on TV, the new trope of the intersex psycho.

There are two times this has happened.  The first is on the show Nip/Tuck.  The character Quentin Costa is a plastic surgeon and a serial rapist called the Carver who mutilates his victim’s faces.  It is revealed that he also has 5 Alpha Reductase Deficiency as a result of incest (not really an indicator for this condition).

The other show is the soap opera Passions.  The character Vincent Clarkson is a murderer, rapist, arsonist and blackmailer.  He has a female alter ego named Valerie.  He also has an unnamed intersex condition and was briefly pregnant.

This trope is very similar to the transgender psycho trope (see Silence of the Lambs, Psycho, and Dressed to Kill).  This is obviously very offensive to intersex and transgender people.  It plays into the ridiculous belief that gender nonconformity is a sign of insanity and possibly violence.  In the case of Quentin, it implied his being mistreated by society was part of what drove him to madness.  It also plays into an ancient belief that hermaphrodites are monstrous.  It is not only offensive, but dehumanizing.   

You could argue that I am being oversensitive, it is only two TV shows after all.  I feel, however, that intersex people are a tiny, relatively unknown minority and two shows can have a disproportionate effect on public perception.  If this is their only reference for intersexuality, of course people will be less open to intersex issues and concerns.  They might even become prejudiced against us.  In any case these shows can only have negative consequences for the intersex community.  Shame on the creators of Nip/Tuck and Passions for creating this trope.  Artistic freedom aside, they may have increased discrimination against us.  Post some comments, let me know what you think.                 

Tuesday, September 2, 2014

D is for Dating

Our last D word is dating.  This is too large an area to really get into in one blog post, so I will focus on the main issue.  The main question intersex (and transgender) people have regarding relationships is: “when do I disclose this to someone I am dating?”  This is a very important question.  Many potential partners will not be accepting of this (or have even heard of intersex).  If the relationship is heterosexual and they feel their sexuality was threatened they may even become violent.  There are four main schools of thought on when to tell.

~ right away.  This is pragmatic.  Get it out in the open before either party has invested much time or emotion into the relationship.  You might end up teaching them about intersex issues if they have never heard of it.  If they can’t accept it they can walk away with no hard feelings.  No muss no fuss.

~ before sleeping together.  Some people feel it is best to let the relationship blossom for a while first.  Let them get to know you and maybe love you first so they are more likely to stay.  Then disclose things before the clothes come off.  Also as you get to know them, and realize they won’t handle the news well, you can call it off before anyone gets too hurt.  At first this seems like a good idea.  The only potential problem is they may feel lead on.  Also if they don’t handle the news well, it will be messier if they have more time and emotion invested into the relationship.

~ never.  This is risky and somewhat radicle.  The line of thought goes cisgender people never have to go disclose their gender identity in a relationship so why should I.  If they truly love me they will accept me.  Or if I have had genital surgery or non-ambiguous genitalia they won’t find out.  Thus there is no reason to tell them since it could destroy the relationship.  Both scenarios are dangerous.  If they get into bed with you and find things are not as they expected, or somehow discover the person they love is not quite what they thought they may become violent.  Even if they may have been accepting, the feeling of being lied to may actually lead to the end of the relationship.

~ be out of the closet to begin with.  This is the option I personally think is the best.  If it is already widely known that you are intersex (or transgender) there will be no need for a big reveal.  They will most likely already know.  If they have been living under a rock and didn’t know, then tell them right away, your safety may depend on it.  As a bonus, if they approach you, you know right off the bat that they are accepting of you.  This is one more reason to come out ASAP.