hello, first I must apologize to my readers, I realize I have not posted on this blog in a very long time, but I was running out of ideas and didn't want to become repetitive. I will try to write more
I am writing today to discuss an event that sometimes occurs when you search for intersex (or trans) issues online, you inevitably run into porn sites. The reason I bring this up is because I was recently reviewing the comments on this blog and realized that some of them were links written in a language my computer could't read. On clicking these links they took me to Asian porn sites. I just wanted to say any porn comments or liks will be deleted. They are off topic and irrelevant to the conversation. Sorry if you were looking for porn, you won't find any here.
Tuesday, February 22, 2011
Wednesday, August 11, 2010
doctor/patient collaboration for surgical consent
Dr. Katrina Karkazis of the Center for Biomedical Ethics at Stanford University recently published a suggested protocol for parents and doctors to reach a decision about whether to operate on intersex babies genitals. This involves 6 steps:
1. develop an appropriate, multidisciplinary team comprised of a variety of subspecialties such as endocrinology, urology, surgery, psychology/psychiatry, gynecology, pediatrics and social work.
2. Establish preferences for information and roles in decision-making. By gauging parents preferences early in the process, physicians can decrease the risk for misunderstanding patient needs and preferences. Physicians are encouraged to perceive and address parents’ emotions, with an emphasis on open communication.
3. Perceive and address emotions, Parents and physicians are uncomfortable discussing certain topics. One example is the future sexual sensation of the child who is potentially going to undergo surgery. Some physicians do not discuss that, although it is something that parents would need to know in order to make an informed decision.
4. Define concerns and values, common parental concerns include fears of teasing, ensuring that the child looks “normal” and using the least treatment intervention possible, all of these things come into play when deciding about surgery, but families rank them differently and it is integral to understand what they want to achieve with surgery and whether the operation will be able to achieve it.
5. Identify options and presenting evidence. Once an understanding of the parent’s needs and goals are established, a presentation of all treatment options and subsequent consequences should be objectively made to the parents. This should realistically explore the risks and benefits of treatment; examine parents’ ideas and assumptions while correcting their misperceptions; and ensure that they understand the nuances of the complex situation.
6. Share responsibility for making a decision. A shared decision must be made by the parents and the team. At this point in the process, parents should possess a technical understanding of the situation while the team will have an appreciation of the families best interests and hopes.
This decision making process does sound like a very small step forward. At least the parents are not panicking and making a rushed decision without all the options and outcomes made known to them. That being said, this suggested process still misses the most important point, it is NOT the parents or doctors decision to make, the only person who has the right to make such a decision is the intersex individual. Anything else is a serious violation of their human rights and bodily integrity, often with disastrous physical and psychological consequences. The only protocol that is needed is to wait until the child is old enough, and give them all the information to make an informed decision.
1. develop an appropriate, multidisciplinary team comprised of a variety of subspecialties such as endocrinology, urology, surgery, psychology/psychiatry, gynecology, pediatrics and social work.
2. Establish preferences for information and roles in decision-making. By gauging parents preferences early in the process, physicians can decrease the risk for misunderstanding patient needs and preferences. Physicians are encouraged to perceive and address parents’ emotions, with an emphasis on open communication.
3. Perceive and address emotions, Parents and physicians are uncomfortable discussing certain topics. One example is the future sexual sensation of the child who is potentially going to undergo surgery. Some physicians do not discuss that, although it is something that parents would need to know in order to make an informed decision.
4. Define concerns and values, common parental concerns include fears of teasing, ensuring that the child looks “normal” and using the least treatment intervention possible, all of these things come into play when deciding about surgery, but families rank them differently and it is integral to understand what they want to achieve with surgery and whether the operation will be able to achieve it.
5. Identify options and presenting evidence. Once an understanding of the parent’s needs and goals are established, a presentation of all treatment options and subsequent consequences should be objectively made to the parents. This should realistically explore the risks and benefits of treatment; examine parents’ ideas and assumptions while correcting their misperceptions; and ensure that they understand the nuances of the complex situation.
6. Share responsibility for making a decision. A shared decision must be made by the parents and the team. At this point in the process, parents should possess a technical understanding of the situation while the team will have an appreciation of the families best interests and hopes.
This decision making process does sound like a very small step forward. At least the parents are not panicking and making a rushed decision without all the options and outcomes made known to them. That being said, this suggested process still misses the most important point, it is NOT the parents or doctors decision to make, the only person who has the right to make such a decision is the intersex individual. Anything else is a serious violation of their human rights and bodily integrity, often with disastrous physical and psychological consequences. The only protocol that is needed is to wait until the child is old enough, and give them all the information to make an informed decision.
Saturday, July 17, 2010
anti-intersex drugs
A medical paper published recently in Australia recommends prenatal screening for congenital adrenal hyperplasia female fetuses. The paper recommends treating them prenatally with dexamethasone to prevent "behavioral masculization" including "same sex attraction and tom boy type behaviors" (there is a much higher statistical rate of both in CAH girls).
I find this absolutely disgusting, it is blatantly homophobic and transphobic. So your little girl may not be what you were expecting, so what? No parent-to-be knows what their child will be like, but they adapt and love them anyways. Parents should love and accept their children not drug out who they are, or will be. This non-consensual medical intervention is little better then genital mutilation, it is the strict enforcement of gender stereotypes at the expense of the humanity, individuality and power of choice of the intersexed individual. It also contributes to the view of intersex as a pathology.
I find the thought of prenatal testing for intersex conditions very disturbing. More prenatal intervention could lead to the abortions intersex fetuses for eugenics purposes. Most parents to be want to know the sex of their baby, but when knowing could lead them to medicate or harm the baby, perhaps it is best left a surprise.
I find this absolutely disgusting, it is blatantly homophobic and transphobic. So your little girl may not be what you were expecting, so what? No parent-to-be knows what their child will be like, but they adapt and love them anyways. Parents should love and accept their children not drug out who they are, or will be. This non-consensual medical intervention is little better then genital mutilation, it is the strict enforcement of gender stereotypes at the expense of the humanity, individuality and power of choice of the intersexed individual. It also contributes to the view of intersex as a pathology.
I find the thought of prenatal testing for intersex conditions very disturbing. More prenatal intervention could lead to the abortions intersex fetuses for eugenics purposes. Most parents to be want to know the sex of their baby, but when knowing could lead them to medicate or harm the baby, perhaps it is best left a surprise.
Wednesday, July 7, 2010
Review of "Fool for Love" by Lisa Lees
I just finished the book Fool for Love by Lisa Lees (available at Amazon, or at lulu.com, a self publishing site). The writing style was a rather choppy, and referenced a lot of things that most intersexuals already know, however I enjoyed reading it and would highly recommend it. Its always nice to see yourself in print, which doesn't happen very often for certain minorities.
Fool for Love is a love story between two high school students, an intersex girl, Jamie, and a genderqueer butch lesbian, Carys. What the book covered very well is the emotional complexities of relationships with intersexuals. Relationships are difficult enough for "normal" people; but for intersexuals, they are an emotional minefield.
Look on any intersex forum and you will see that intersex people have a lot of apprehension and angst about relationships. Their genitals have been a source of great emotional anguish, and sharing them with another is sometimes too painful.
This is why I liked Fool for Love, it showed that in spite of all these fears, love can prevail and intersexuals can have a happily ever after.
Fool for Love is a love story between two high school students, an intersex girl, Jamie, and a genderqueer butch lesbian, Carys. What the book covered very well is the emotional complexities of relationships with intersexuals. Relationships are difficult enough for "normal" people; but for intersexuals, they are an emotional minefield.
Look on any intersex forum and you will see that intersex people have a lot of apprehension and angst about relationships. Their genitals have been a source of great emotional anguish, and sharing them with another is sometimes too painful.
This is why I liked Fool for Love, it showed that in spite of all these fears, love can prevail and intersexuals can have a happily ever after.
Monday, June 28, 2010
the amusing risks of ultrasounds
Hello readers, remember a few posts ago when I wrote about using humor at an ultrasound to ease the tensions? Well, I got the results back from the ultrasound and wouldn't you know it, it said I had ovaries, even though my gonads had been removed as a small child. The report went so far as to say my reproductive system was "unremarkable". To say I was shocked by this would be an understatement. There were only four explanations I could think of:
1. The surgeons removed the wrong thing, and I still had my gonads
2. The ultrasound had been misread
3. Like some of my hermaphrodite brethren, the earthworms and sponges, I had the ability to regenerate lost body parts
4. There was a mix up and I was given someone else's ultrasound result (I hoped this was not the case because some poor "normal" lady would be in for an even worse shock then me if she got my ultrasound)
As it turns out, it was number 2. In a case of confirmation bias, the ultrasound tech expected to see ovaries, and thus mislabeled loops of my colon as ovaries. The moral of this story is when things seem weird, ask questions of your doctors. We deserve to know the truth
1. The surgeons removed the wrong thing, and I still had my gonads
2. The ultrasound had been misread
3. Like some of my hermaphrodite brethren, the earthworms and sponges, I had the ability to regenerate lost body parts
4. There was a mix up and I was given someone else's ultrasound result (I hoped this was not the case because some poor "normal" lady would be in for an even worse shock then me if she got my ultrasound)
As it turns out, it was number 2. In a case of confirmation bias, the ultrasound tech expected to see ovaries, and thus mislabeled loops of my colon as ovaries. The moral of this story is when things seem weird, ask questions of your doctors. We deserve to know the truth
Wednesday, June 23, 2010
cultural compromise and genital integrity
a hot button issue for intersex activists lately has been the recent change in the protocol of the American Academy of Pediatrics (AAP). This change is the AAP's recommendation that the US permit doctors to "nick" the genitals of their female patients as a compromise for their African patients seeking their ritual genital cutting. They have said this is justified on three grounds.
1. nicking is very minor, the equivalent to a pin prick or an ear piercing.
2. it demonstrates a cultural sensitivity for immigrant populations
3. it is a compromise that could prevent the parents from preforming more extreme genital cutting.
This is unusual since AAP's previous statement on the subject states (rightly so) that female genital cutting is a form of gender based violence. Even if this nicking sound harmless, it is important to not quibble over severity, if something is wrong, then milder forms of it are still wrong. Many anti-FGM activists fear, rightly so, that this recommendation opens up shades of gray which will muddle and ultimately set back their movement.
FGM is very similar to the way intersex people are treated in America, our genitals are cut up to satisfy a sociocultural requirement. The similar lack of respect for bodily integrity and sexual autonomy due to culture is striking Many intersex activists petitioned congress to add intersex to the Federal Prohibition of Female Genital Mutilation Act, citing these similarities. Obviously Congress was not persuaded. I think it is very important to understand understand other cultures, but it is also important to realize that cultures are not static, they change all the time. There are many African activists working to stop female genital mutlation in their culture. I think the American Academy of Pediatrics did these activists a great disservice by stabbing them in the back with this recommendation. In any case, no child should be put in harms way just because of cultural norms, that is deeply unethical, and suggests a norm that needs to be changed.
1. nicking is very minor, the equivalent to a pin prick or an ear piercing.
2. it demonstrates a cultural sensitivity for immigrant populations
3. it is a compromise that could prevent the parents from preforming more extreme genital cutting.
This is unusual since AAP's previous statement on the subject states (rightly so) that female genital cutting is a form of gender based violence. Even if this nicking sound harmless, it is important to not quibble over severity, if something is wrong, then milder forms of it are still wrong. Many anti-FGM activists fear, rightly so, that this recommendation opens up shades of gray which will muddle and ultimately set back their movement.
FGM is very similar to the way intersex people are treated in America, our genitals are cut up to satisfy a sociocultural requirement. The similar lack of respect for bodily integrity and sexual autonomy due to culture is striking Many intersex activists petitioned congress to add intersex to the Federal Prohibition of Female Genital Mutilation Act, citing these similarities. Obviously Congress was not persuaded. I think it is very important to understand understand other cultures, but it is also important to realize that cultures are not static, they change all the time. There are many African activists working to stop female genital mutlation in their culture. I think the American Academy of Pediatrics did these activists a great disservice by stabbing them in the back with this recommendation. In any case, no child should be put in harms way just because of cultural norms, that is deeply unethical, and suggests a norm that needs to be changed.
Saturday, June 19, 2010
American Female Genital Mutilation
If you are standing (at the computer, that would be weird) you should sit down, the news I have to report is shocking.
Dr. Dix Poppas, a pediatric urologist at Cornell University has been surgically shortening the clitoris's of girls who have been deemed to be too big and too sensitive (God forbid a woman actually enjoy sex). Then at follow up examinations he uses a vibrator to test how much sensitivity is lost. I for one am outraged by this. The mutilation and molestation of children is sick. No other pediatric urologist preforms this procedure. What kind of parents would allow this to happen to their little girl? There is nothing wrong with these girls, it is a completely subjective, aesthetic judgment (I shudder to think what these parents would do with an intersex child).
The fact that Dr. Poppas does these vibrator follow-ups shows he is aware of the risks. In spite of this he goes forward with the surgery, violating his Hippocratic oath and demonstrating a disturbing lack of respect for his patients humanity. Look up any intersex discussion board to realize how psychologically devastating genital surgeries and especially the repeated examinations and poking and prodding are on children. These posters are adults who are still not over it. Emotionally they are very much like victims of child sexual abuse.
Even if, as he claims, that he is proving that the sensitivity loss is minimal, it is still wrong. Even if genital surgeries were perfect (they never are, the results are often quite terrible) I would say that it is horribly unethical. Whatever happened to learning to accept yourself, this turning to plastic surgery to solve our insecurities is deeply problematic. It is important to feel at home in your own skin, and when you are implicitly told that you are so unacceptable that we have to operate, it is very difficult to learn that self acceptance.
Dr. Dix Poppas, a pediatric urologist at Cornell University has been surgically shortening the clitoris's of girls who have been deemed to be too big and too sensitive (God forbid a woman actually enjoy sex). Then at follow up examinations he uses a vibrator to test how much sensitivity is lost. I for one am outraged by this. The mutilation and molestation of children is sick. No other pediatric urologist preforms this procedure. What kind of parents would allow this to happen to their little girl? There is nothing wrong with these girls, it is a completely subjective, aesthetic judgment (I shudder to think what these parents would do with an intersex child).
The fact that Dr. Poppas does these vibrator follow-ups shows he is aware of the risks. In spite of this he goes forward with the surgery, violating his Hippocratic oath and demonstrating a disturbing lack of respect for his patients humanity. Look up any intersex discussion board to realize how psychologically devastating genital surgeries and especially the repeated examinations and poking and prodding are on children. These posters are adults who are still not over it. Emotionally they are very much like victims of child sexual abuse.
Even if, as he claims, that he is proving that the sensitivity loss is minimal, it is still wrong. Even if genital surgeries were perfect (they never are, the results are often quite terrible) I would say that it is horribly unethical. Whatever happened to learning to accept yourself, this turning to plastic surgery to solve our insecurities is deeply problematic. It is important to feel at home in your own skin, and when you are implicitly told that you are so unacceptable that we have to operate, it is very difficult to learn that self acceptance.
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