Why Are Intersex Babies Treated as a Medical Emergency?

SCHOOL OF LANGUAGE, SOCIAL AND POLITICAL SCIENCES

Department of Sociology and Anthropology

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SOCI111

Discuss why the birth of an intersex baby is treated as a ‘medical emergency’ and the implications of surgical sex assignment (personally and socially)

Is it a boy or a girl? One of the first questions most new parents ask the doctor, however for approximately 1 in every 1500 babies the answer is not always as straight forward as they assume (American Psychological Association, 2006). Infants with ambiguous genitalia are known as intersex, gender assignment is not clear for these children as they have both male and female genitalia. The common medical practice has been to operate on the infant and assign them one sex, however this practice is not always medically needed and can lead to many negative side effects.

There are two main views of intersex. Firstly, that it is an abnormality which is likely to lead to great distress in both the individual and family, that intersex is pathological and requires immediate medical attention. The second view that it is a common anatomical variation and is neither medical or a social pathology.

The common medical response to intersex babies follows the idea that it is an abnormality, doctors perform genital surgery in infancy to make genitals look more ‘normal’.

This is done because doctors and parents are distressed by the appearance of intersex genitalia. They believe gender reassignment surgery will make a child’s life easier and less distressing.

John Money proposed that successful sexual reassignment was possible if it was carried out before a critical age, and if the child was raised unquestionably in the gender role consistent with their new sex (Money, Hampson and Hampson, 1995, as cited in Morgan, 2002). In order to ensure surgery would occur before the critical age, the birth of an intersex infant is framed as a ‘psycho-sexual emergency’ that needed to be addressed as soon as possible.

However, when referring to Eric Parens’ well known classification of medical procedure as either ‘enhancements’ or ‘treatments’, the current surgical practice of intersex children fits neither category.  (Parens, 1998: 1-15). According to Parens to be considered a treatment, a procedure must restore a specific or potential ability that allows a person to compete at an even level to their peers. It aims to restore a bodily function required for autonomy and independence. An enhancement permits a person to perform at a higher standard.  

Gender reassignment surgery does neither of these, nothing has been ‘lost’ as often people who have had surgery are left with a decreased self image and impaired bodily functions.

In our society we take for granted that sex has two categories; male and female. In school we learn that sex is created by chromosomes, XX for female and XY for male. This knowledge is reinforced in social classes and the world around us, where we learn about the social constructions of gender.  This has led to our society being predominantly two sexes. Intersex babies are seen as abnormal because they do not fit in with this binary sex system.

For many parents, it is shocking to realise that the binary sex model is not always valid. Since the model is not only a theoretical tool, but also something they live by, they are forced to question the way they view sex.

This can lead to confusion for parents who do not understand why doctors cannot clearly state what sex their child is based on their external genitals. This questions the idea that sex is primarily to do with genitals. There is a general expectation that all humans will fit into one of the two clearly defined categories.

Clinicians suggest that not performing gender reassignment surgery will result in children being raised without a clear gender identity, and thus not fit in. This idea implies

 that surgery is needed to protect him or her from a hostile and unwelcoming world, that surgery is in the best intentions of the child and parent. However, this idea makes many assumptions that are not true. Firstly, that un-gendered people would not have clear identities. Secondly, that people born with either male or female genitalia feel comfortable in their bodies and gender identity. This idea implies that being intersex will lead to a lifetime of confusion and identity crises, while being typically gendered will ensure a smooth path to adulthood and contentment.

When parents learn that their child is intersex, a condition no commonly encountered they may feel lost and look to doctors for support. When intersex is framed as a medical emergency they may think medical treatment is logical. As a society we have given medicine the authority to police the boundaries of male and female. Our fixation on cosmetic concerns is a large part of our culture and world. In this way, it is difficult to separate medicine from society. This has led to giving doctors the freedom and authority to operate on intersex babies under the guise of a medical emergency, to ‘normalise’ them. The perspective of two sexes frames intersex as a medical abnormality that doctors feel need to be rectified and ‘normalised’ for the benefit of the parents and child.