Doctors Abuse Patients with Intersex Conditions

During his famous and infamous career, John Hopkins psychologist John Money revolutionized the way society viewed gender, popularizing the notion that nurture was as powerful as nature in the creation of gender identity.

Unfortunately, Money possessed an unhealthy dose of hubris, and tested his theories by performing sex reassignment surgeries on infants and toddlers who had ambiguous genitalia and other conditions. Horrific doubt was cast upon his treatments when one of his patients, David Reimer, committed suicide.

As an infant, Reimer's penis had been mangled in a circumcision accident. Money, believing sexuality was "malleable" at that age, removed it and turned Reimer into a girl. Reimer never identified as a woman, struggled with his identity for most of his life, later castigated Money and eventually took his own life.

Though Reimer was the victim of a terrible accident, many of Money's patients were people who were born with what are now called Intersex conditions. This is different from transexuality, which describes people who have transitioned or are transitioning to a gender that's different from their assigned sex.

An Intersex condition is an incongruence between a person’s outward appearance and their genitals, hormones, chromosomes or internal reproductive anatomy. Intersex covers a wide spectrum of conditions that can range from an enlarged clitoris to an unusual endocrine system. In some cases, there is cause for medical concern, but more often than not there is nothing medically malevolent about these conditions other than the fact they are abnormal or that Intersex bodies might not fit rigid ideas of gender.

People with Intersex conditions have long been voiceless, largely because the sensationalism and shame that often surrounds their conditions motivates them to stay anonymous. But increasingly they are speaking out against the medical establishment. Many have stories that parallel Reimer's, stories of their gender being reassigned or their condition "corrected" at an early age and subsequently suffering a lifetime of psychological turmoil.

To help protect their medical rights, activist organizations such as the Intersex Initiative in Portland and the Advocates for Informed Choice are advocating that people with Intersex conditions be allowed to make their own decisions about their bodies. They promote a "patient-centered" treatment to replace the old model of secrecy and correction.

In other words, doctors should not be performing radical procedures on children with Intersex conditions. Instead patients and their parents should be supported medically and emotionally to help them cope with the social difficulties. When they become adults, then they can decide whether they want surgeries or other treatments. The doctors shouldn't decide for them.

Unfortunately, not all physicians are listening, and some are still wielding their power over Intersex patients with the same hubris and myopic views that Money once did.

In a study conducted under the auspices of the Weill Medical College of Cornell University, pediatric urologist Dix Poppas has performed clitoral reduction surgeries on a group of young girls and teenagers. He performed the operations after deeming the clitorises to be "too big" even though there is no medical evidence possessing an unusually large clitoris has any increased medical or psychological risk.

Even more disturbing, he has followed up these surgeries by conducting "clitoris sensitivity" tests on girls as young as six. The patients are conscious when Poppas uses a Q-tip or vibratory device to stimulate the inner thigh, outer and inner labia and the clitoris of patients to test how much sensitivity they retained after the surgery.

After publishing a paper about his work, controversy erupted and Weill Medical College conducted an internal investigation, eventually finding nothing wrong with Poppas's procedures and stating they are "part of the evaluation of the clinicial success of the surgical procedure and health of the patient." There seems to be no consideration as to whether the follow up tests might have any emotional or psychological effects on the young girls.

The AIC says that Cornell refuses to answer questions about whether these patients will receive normal protections given human research subjects and what kind of information parents receive when making decisions about genital surgery. Also according to the AIC, the federal Office of Human Research Protections is starting to evaluate the matter.

The tragic history of Intersex is rife with stories of physicians like Dr. Poppas who exert control and judgment over Intersex patients that doesn't belong to them .

Tell Dr. Poppas and Weill Medical College to stop the abuse of Intersex patients and to respect their rights. Demand they immediately stop these experiments and allow advocacy groups to help educate the parents of their patients about the true nature of ambiguous genitalia and Intersex conditions.

Marc Dadigan is a freelance multimedia reporter living with the Winnemem Wintu in Northern California. Read more at www.marcdadigan.com.