Guidance for Parents?

Guidance for Parents?

Blog #1

By Chloe Lattin

            Last summer, I shadowed a very accomplished pediatric surgeon, Dr. F., in Cleveland who specialized in sex surgeries among other things. He did a lot of great work to make sure the sex organs and urinary tracts functioned for these young patients. I really respected Dr. F. and valued how he treated his patients; however, there was one instance in which I had a hard time grappling with his beliefs. I met Patient 1 whom had been with Dr. F. since birth. He was probably around 6 years of age when I met him and was raised as a boy. The unique thing about Patient 1 was that he had been born without a penis or a clear vagina. He had what doctors refer to as a cloaca or a hole that passes both liquid and solid waste. At birth, doctors suggested that because this boy did not have a penis his parents should raise him as a girl because it would be “easier.” However, the boy had testes and had male chromosomes, so the family decided to raise him as a boy. When Dr. F. and I later discussed Patient 1, he admitted that he had thought that the family was making the wrong decision and while he valued the patient and the family, he still thought they had made the wrong decision.

            Later that summer, I encountered another patient, a boy who had a penis but his testicles had not descended. His father, who was a doctor at the hospital, was insistent on having the boy’s testicles surgically descended in order to make his genitalia look “normal.” The doctors were concerned that if they pulled the testicles down before the boy had stopped growing, then it could result in lasting damage and the testicles might ascend and cause scar tissue build up. Despite the fact that the father was a doctor, he was so set on what his son’s genitalia looked like, that he wanted a risky surgery to be performed. While this patient did have a penis, which corresponded to his sex chromosomes, it was interesting to see how Dr. F. refused to allow a surgery that could have caused physical harm, however, encouraged a surgery that could have caused emotional harm and confusion to Patient 1. A number of articles have discussed how sex assignment surgery can cause lasting damage when performed on the patient at too early of an age and the parents can make the wrong decision in the eyes of the patients.

            When I think back on these two patients and how I questioned what was happening and lacked the vocabulary to vocalize my opinions I have only grown more confused after reading Reis’s piece “Divergence or Disorder” which aims to shed light on how we define disorder of sex development (DSD). While I felt uneducated on Patient 1, I am sure the parents initially felt even more uneducated. The common term for people born outside of the clear binaries of sex is intersex. However, this term is being phased out because it “suggests a self-conscious alternative gender identity and sexuality” not for the patient, but for the patient’s parents (Reis, 535). Many of the concerns Reis makes in “Divergence or Disorder?” take into account how the parents feel, without thinking about the needs of the child. This is a difficult situation because these “issues” of intersex arise usually at birth and before the child is able to make decisions for him or herself. Reis continues to focus on the concern of the parent instead of the patient. Despite age, it seems like parents need to be better educated on what to do, without the pressure of doctors and society to make a quick decision in order to start raising their child the “right” way. When I researched ‘intersex parenting’ an article in Parents Magazine was the first to pop up. The article leads with how in Germany, a child can legally be neither male nor female on their birth certificate. I thought that this would set the tone and direction of the article perhaps trying to break down binaries, however, in the first step under “What should you do if your child is intersex?” the first recommendation is to assign a gender, based on “what the child is likely to feel as she or he grows up.” http://www.parents.com/parenting/intersex/

If parents wanted to wait until their child could express themselves regardless of their chromosomes or genitalia or sex organs, they would likely receive little to no guidance. They could not rely on the support of doctors, who encourage parents to immediately assign a gender to the child and the first website to appear online shares the same views as most doctors. Breaking down sex and gender binaries can be done by parents who often make the decisions for their young children, however, without the support of doctors and online resources this can be very challenging. I admired the mother and family of Patient 1 who chose to raise their child based on his chromosomes instead of his lack of genitalia. While maybe this family did not need to assign a sex to their child, the mother followed her instinct despite recommendations from the doctors and perhaps this is the first step.

           

When I googled cartoon children, these minions were the only image that did not contain children that were clearly male or female.

Reis, Elizabeth. “Divergence or Disorder?” Perspectives in Biology and Medicine 50.4 (2007): 535-41. Print.