It is the third word said about each of us and the answer to the first question ever asked about all of us: boy or girl. When a baby is born a doctor looks at their genitals. If the doctor sees a penis they declare, “Its a boy!” If the doctor does not see a penis they declare, “Its a girl!” Then a permanent “M” or “F” is inscribed on the infant’s birth certificate that will follow them for the rest of their life. The new arrival’s gender becomes government record before the child even knows what gender is let alone their place in it.

When new parents announce a birth the first question on everyone’s mind is, “Is it a boy or a girl?” Then the parents dress the newborn in either pink or blue to make sure there is no confusion over the appearance of the child’s genitals and, by extension, which gender within the binary they are raising the child to be for the rest of their life. If the parents inquired what their expected child’s reproductive anatomy looked like on a prenatal ultrasound they begin to gender the coming baby before the child even comes out of the womb. This early gendering sets into a motion an array of behaviors from buying certain toys, clothes, and decorations to choosing from only certain names, throwing “gender reveal” parties, and forming strong expectations regarding the infant’s future. These expectations are oftentimes so strong any break with them is met with pain, grief, distress, fear, anger, and violence.

For those of us who are intersex, being assigned a gender can be a source of great pain. When doctors cannot determine a baby’s sex immediately a medical emergency is set in motion. Surgeons are called in, endocrinologists are consulted, whole medical teams are formed, tests are administered, and the offending ambiguous body parts are surgically modified to fit into what the wider society has deemed to be standard for male or female. In most cases parents are not even consulted on these decisions and if they are consulted they are usually pressured into going along with normalizing procedures regardless of medical necessity or the serious life long consequences for the child, which often include sterility and lose of genital feeling. Not to mention all of the ethical issues surrounding the hormonal treatments many intersex people go through in adolescence in an effort to keep shoe horning them into the side of the gender binary to which they were assigned regardless of their actual sense of self.

Then there are those of us who are trans and do not identify with the gender we were assigned at birth. Such an early misidentification often leads to a great deal of distress and struggle in a society built on a strict binary. Trans people are more likely to attempt suicide, face violence, be denied health care, and experience poverty as a result of institutionalized cissexism and transphobia with trans women of color being particularly vulnerable. For many of us in the trans community our birth assigned genders are horrible mistakes we spend a lifetime correcting at great personal risk.

In many ways the different experiences of interphobia and transphobia intersect in how the medical gaze aggressively genders bodies from birth to death with no room for variation even in newborns. The surgeries many trans people elect to undergo in the process of affirming their gender identities had their start being performed on intersex infants and children who could not consent to such procedures. The same hormonal treatments trans people have to go through all kinds of hoops to gain access to are given without any question to intersex children. Both intersex and trans people find themselves having to educate medical professionals about their bodies in ways their non-intersex and cisgender counterparts never do. Those of us who live at the intersections of intersexuality and transness find our experiences are incoherent even within trans and intersex communities. All of this has at least some roots in deeply entrenched cultural beliefs that gender is easily recognizable at birth, binary, natural, biologically determined, and fixed. These are the cultural beliefs that make grown people think they know who a child is based on their genitalia and lead them to be fearful whenever faced with any challenge to those beliefs, even when said challenge comes in the form of a helpless baby.

This is the reality of birth and gender in twenty-first century America, where a simple “M” or “F” plays a role in determining the civil rights and privileges a person is afforded in important areas of life and being intersex or trans is met with oppression. Fortunately there are signs these practices are changing for the better. Transgender adults and children, in particular, are gaining visibility. Nonbinary identities are becoming better known to the general public. Intersex activists have made strides in raising awareness and working toward changing intersex health care. More parents are questioning and even out right resisting societal pressures to impose a particular gender on their children based solely on genitalia, especially when they are only infants.

I dream of a day when we put our babies in rainbow hats and are not so quick to assign gender to infants, or at least learn to take such assignments with a grain of salt. Besides a gender assignment at birth doesn’t yield all the information we are told it does even when it comes to biology. No one is testing the karyotypes of babies or conducting ultrasounds of their internal reproductive systems let alone thinking of the possibility the child may be trans. For all anyone knows in those first moments of life the healthy newborn everyone assumes has ovaries, a uterus, and XX chromosomes because the doctor said its a girl actually has internal testes and  XY chromosomes or the baby the doctor so confidently declared to be a boy due to the presence of a penis may one day disagree with that doctor’s assessment and grow up to be a woman.

So the next time someone you know has a baby maybe just ask if the baby is healthy rather than the classic, “Is it a boy or a girl?” Afterall you’re asking about a baby. No one knows who they are yet.

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